Table 1 Multivariate analysis for factors associated with antibiotic over-prescription for diarrheal children under 5 years old without dysentery in Asembo (N = 2685)
From: Inappropriate use of antibiotics for childhood diarrhea case management — Kenya, 2009–2016
Factors | Antibiotic prescribed (%) | Antibiotic not prescribed (%) | Crude odds ratio (95% CI) | Adjustedb odds ratio (95% CI) |
|---|---|---|---|---|
Demographics | ||||
Age < 1 | 545/1410 (38.3%) | 408 /1275 (32.0%) | 1.32 (1.13–1.55) | |
Male | 745/1410 (52.8%) | 707/1275 (55.5%) | 1.11 (0.95–1.29) | |
Recent medical history | ||||
Clinic visit within 14 days | 182/1410 (12.9%) | 127/1275 (10.0%) | 1.34 (1.05–1.70) | |
Clinic visit within 14 days with diarrheal symptom | 43/1406 (3.1%) | 25/1270 (2.0%) | 1.57 (0.95–2.59) | |
Clinic visit within 14 days with antibiotic treatment | 64/1410 (4.5%) | 42/1275 (3.3%) | 1.40 (0.94–2.08) | |
Signs and symptoms | ||||
Weight-for-age < −2 | 263/1395 (18.9%) | 254/1262 (20.1%) | 0.92 (0.76–1.12) | |
Height-for-age < −2 | 369/1320 (28.0%) | 324/1201 (27.0%) | 1.05 (0.88–1.25) | |
Weight-for-height < −2 | 182/1302 (14.0%) | 182/1181 (15.4%) | 0.89 (0.71–1.11) | |
Measured or reported fever | 1158/1410 (82.1%) | 1112/1275 (87.2%) | 0.67 (0.54–0.83) | |
Cough | 691/1410 (49.0%) | 601/1275 (47.1%) | 1.08 (0.93–1.25) | |
Difficulty breathing | 12/1409 (0.9%) | 11/1274 (0.9%) | 0.99 (0.43–2.24) | |
Sore throat | 12/1358 (0.9%) | 4/1266 (0.3%) | 2.81 (0.90–8.72) | 5.03 (0.73–34.91) |
Vomiting | 469/1410 (33.3%) | 462/1272 (36.3%) | 0.87 (0.75–1.03) | 0.79 (0.58–1.07) |
Runny nose | 477/1410 (33.8%) | 416/1275 (32.6%) | 1.06 (0.90–1.24) | |
Sneezing | 251/1409 (17.8%) | 202/1275 (15.8%) | 1.15 (0.94–1.41) | |
Physical examination | ||||
Restless or irritable | 80/1409 (5.7%) | 46/1270 (3.6%) | 1.60 (1.11–2.32) | 1.39 (0.81–2.40) |
Sunken eyes | 128/1408 (9.1%) | 78/1270 (6.1%) | 1.53 (1.14–2.05) | 1.22 (0.80–1.84) |
Drinks eagerly, thirsty | 58/1407 (4.1%) | 36/1268 (2.8%) | 1.47 (0.96–2.25) | |
Skin tenting | 87/1405 (6.2%) | 46/1270 (3.6%) | 1.76 (1.22–2.53) | |
Signs of anemia | 30/1378 (2.2%) | 36/1243 (2.9%) | 0.75 (0.46–1.22) | |
Crackles/rales | 3/1408 (0.2%) | 6/1272 (0.5%) | 0.45 (0.11–1.81) | |
Clinical diagnoses | ||||
Gastroenteritis | 1292/1410 (91.6%) | 792/1275 (62.1%) | 6.68 (5.36–8.32) | 8.23 (3.68–18.40) |
Malaria | 322/1410 (22.8%) | 660/1275 (51.8%) | 0.27 (0.23–0.33) | 0.37 (0.25–0.54) |
Dehydration | 123/1410 (8.7%) | 66/1275 (5.2%) | 1.75 (1.28–2.39) | |
URTIa | 415/1410 (29.4%) | 352/1275 (27.6%) | 1.09 (0.93–1.29) | |
Prescription | ||||
Concurrent ORSa | 1130/1410 (80.1%) | 830/1275 (65.1%) | 2.16 (1.82–2.58) | 0.49 (0.33–0.71) |
Concurrent zinc | 765/1410 (54.3%) | 714/1275 (56.0%) | 0.93 (0.80–1.09) | |