Table 2 Multivariate analysis for factors associated with antibiotic over-prescription for diarrheal children under 5 years old without dysentery in Kibera (n = 4518)
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 | 194/904 (21.5%) | 938/3614 (26.0%) | 0.78 (0.65–0.93) | 0.82 (0.71–0.94) |
Male | 445/904 (49.2%) | 1763/3614 (48.8%) | 1.02 (0.88–1.19) | |
Recent medical history | ||||
Clinic visit within 14 days | 111/904 (12.3%) | 456/3614 (12.6%) | 0.97 (0.77–1.21) | |
Clinic visit within 14 days with diarrheal symptom | 40/872 (4.6%) | 147/3446 (4.3%) | 1.08 (0.75–1.54) | |
Clinic visit within 14 days with antibiotic treatment | 39/904 (4.3%) | 78/3614 (2.2%) | 2.04 (1.38–3.02) | 2.51 (1.72–3.69) |
Signs and symptoms | ||||
Weight-for-age < −2 | 164/888 (18.5%) | 625/3567 (17.5%) | 1.07 (0.88–1.29) | |
Height-for-age < − 2 | 313/806 (38.8%) | 1255/3010 (41.7%) | 0.89 (0.76–1.04) | |
Weight-for-height < −2 | 58/792 (7.3%) | 233/2989 (7.8%) | 0.94 (0.69–1.26) | |
Measured or reported fever | 188/902 (20.8%) | 360/3605 (9.99%) | 2.37 (1.96–2.88) | 2.24 (1.56–3.23) |
Cough | 505/904 (55.9%) | 1667/3612 (46.2%) | 1.48 (1.28–1.71) | 1.42 (1.06–1.90) |
Difficulty breathing | 8/865 (0.9%) | 7/3185 (0.2%) | 4.23 (1.53–11.72) | 3.97 (1.28–12.30) |
Sore throat | 6/901 (0.7%) | 24/3599 (0.7%) | 1.00 (0.41–2.45) | |
Vomiting | 98/904 (10.8%) | 575/3611 (15.9%) | 0.64 (0.51–0.81) | 0.74 (0.53–1.03) |
Runny nose | 491/904 (54.3%) | 1848/3612 (51.2%) | 1.13 (0.98–1.31) | |
Sneezing | 97/903 (10.7%) | 480/3612 (13.3%) | 0.79 (0.62–0.99) | 0.74 (0.40–1.38) |
Physical examination | ||||
Restless or irritable | 8/903 (0.9%) | 33/3585 (0.9%) | 0.96 (0.44–2.09) | |
Sunken eyes | 11/904 (1.2%) | 58/3591 (1.6%) | 0.75 (0.39–1.44) | |
Drinks eagerly, thirsty | 11/904 (1.2%) | 33/3598 (0.9%) | 1.33 (0.67–2.64) | |
Skin tenting | 10/904 (1.1%) | 45/3592 (1.3%) | 0.88 (0.44–1.76) | |
Signs of anemia | 1/901 (0.1%) | 9/3598 (0.3%) | 0.44 (0.06–3.50) | |
Crackles/rales | 32/904 (3.5%) | 41/3614 (1.1%) | 3.20 (2.00–5.11) | 2.66 (1.34–5.30) |
Clinical diagnoses | ||||
Gastroenteritis | 670/904 (74.1%) | 2555/3588 (71.2%) | 1.16 (0.98–1.37) | 1.62 (0.94–2.80) |
Malaria diagnosis | 15/904 (2.0%) | 94/3588 (2.6%) | 0.63 (0.36–1.09) | |
Dehydration | 5/904 (0.6%) | 44/3588 (1.2%) | 0.45 (0.18–1.13) | |
URTIa | 415/904 (45.9%) | 1651/3588 (46.0%) | 1.00 (0.86–1.15) | 0.82 (0.52–1.31) |
Treatment | ||||
Concurrent ORSa | 578/904 (63.9%) | 2420/3614 (67.0%) | 0.88 (0.75–1.02) | 0.81 (0.54–1.22) |
Concurrent zinc | 335/904 (37.1%) | 1327/3614 (36.7%) | 1.02 (0.87–1.18) | |