Journal of Pediatrics Review
Journal of Pediatrics Review
J. Pediatr. Rev
Medical Sciences
http://jpr.mazums.ac.ir
1
admin
2322-4398
2322-4401
10.32598
en
jalali
1399
10
1
gregorian
2021
1
1
9
1
online
1
fulltext
en
Early Hospitalization Reduces the Length-of-Hospital Stay and Antibiotic Use in Children With Moderate Diarrhea: A Study in Bangladesh
Pediatric Infectious Diseases
Original Article
Original Article
<strong>Background</strong>: Childhood diarrheal diseases are common with mild-to-severe mortality rate worldwide. Lower-middle-income countries (LMICs), including Bangladesh in South Asia, are still unable to save their under-5 lives due to diarrheal conditions.<br>
<strong>Objectives</strong>: The main aim of this study was to evaluate the duration of hospital stay and use of antibiotics in under-2 children with moderate diarrhea in Bangladesh. <br>
<strong>Methods</strong>: This study was done on hospitalized 6 months to 2 years old pediatric patients (n=212) with an uncontrolled moderate type of diarrhea in 3 districts of Bangladesh. Based on the history of diarrhea onset, 133 and 79 patients were allocated in the early hospitalization (EH) and delayed hospitalization (DH) groups, respectively.<br>
Results: To treat uncontrolled diarrhea at home, antibiotic therapy was initiated in 36.7% of patients in the DH group without any valid prescription, whereas only 7.5% of patients in the EH group received antibiotics (P<0.05). In the DH group, 67.1% of children received different antibiotic therapies for treating their diarrhea with or without other hospital-acquired infections during their extended hospital-stay period, resulting in antibiotic-associated adverse events (AAAEs) in 17.7% of the patients. At the same time, 21.1% of the patients in the EH group received antibiotics that caused AAAEs in 2.2% of them (P=0.001). The EH group, who received doctors’ consultations and hospitalized within 2 days of the onset of diarrhea, stayed in the hospital for a maximum of 4 days. It was less than half a time that of the children in the DH group (P<0.05) (stayed for a maximum of 10 days), who visited doctors and admitted to hospitals at a later stage of diarrheal-onset.<br>
<strong>Conclusions</strong>: Early doctor visits and hospitalization of under-2 children with uncontrolled moderate diarrhea may reduce the severity of the disease and risk of severe acute malnutrition, minimize the use of antibiotics with minimum chance of occurrence of adverse drug events, and cause early discharge from hospital.
Diarrhea, Children, Bangladesh, Malnutrition, Antibiotic, Adverse drug event
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http://jpr.mazums.ac.ir/browse.php?a_code=A-10-916-1&slc_lang=en&sid=1
Md. Jahidul
Hasan
jahidul@squarehospital.com
10031947532846006603
10031947532846006603
Yes
Clinical Pharmacy Services, Department of Pharmacy, Dhaka, Bangladesh.
Md.
Suman
hasansumon34@yahoo.com
10031947532846006604
10031947532846006604
No
Matlab Health Research Centre, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh.