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Table 3 Multivariate analysis for factors associated with antibiotic under-prescription for diarrheal children under 5 years old with dysentery in Western Kenya, Asembo (n = 123)

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

29/90 (32.2%)

12/33 (36.4%)

1.20 (0.52–2.77)

 

 Male

50/90 (55.6%)

13/33 (39.4%)

0.52 (0.23–1.17)

 

Recent medical history

 Clinic visit within 14 days

8/90 (8.9%)

3/33 (9.1%)

1.03 (0.26–4.12)

 

 Clinic visit within 14 days with diarrheal symptom

4/90 (4.4%)

1/33 (3.0%)

0.67 (0.07–6.24)

 

 Clinic visit within 14 days with antibiotic treatment

5/90 (5.6%)

0/33 (0%)

N/A

 

Signs and symptoms

 Weight-for-age < −2

17/89 (19.1%)

9/33 (27.3%)

1.59 (0.63–4.03)

 

 Height-for-age < −2

22/85 (25.9%)

6/30 (20.0%)

0.72 (0.26–1.98)

 

 Weight-for-height < −2

14/85 (16.5%)

5/30 (16.7%)

1.02 (0.33–3.10)

 

 Measured or reported fever

81/90 (90.0%)

31/33 (93.9%)

1.72 (0.35–8.42)

 

 Cough

54/90 (60.0%)

22/33 (66.7%)

1.33 (0.58–3.08)

 

 Difficulty breathing

1 /90 (1.1%)

0/33 (0%)

N/A

 

 Sore throat

1/89 (0.9%)

0/32 (0%)

N/A

 

 Vomiting

23/90 (25.6%)

18/33 (54.5%)

3.50 (1.52–8.04)

4.36 (1.98–9.57)

 Runny nose

27/90 (30.0%)

10/33 (30.3%)

1.02 (0.43–2.42)

 

 Sneezing

13/90 (14.4%)

6/33 (18.2%)

1.32 (0.46–3.81)

 

Physical examination

 Restless or irritable

7/90 (7.8%)

2/33 (6.1%)

0.77 (0.15–3.88)

 

 Sunken eyes

8/90 (8.9%)

3/33 (12.1%)

1.41 (0.40–5.05)

 

 Drinks eagerly, thirsty

4/90 (4.4%)

1/33 (3.0%)

0.67 (0.07–6.24)

 

 Skin tenting

4/90 (4.4%)

0/33 (0%)

N/A

 

 Signs of anemia

4/88 (4.6%)

0/32 (0%)

N/A

 

 Crackles/rales

0/90 (0%)

0/33 (0%)

N/A

 

Clinical diagnoses

 Gastroenteritis

42/90 (45.6%)

10/33 (30.3%)

0.52 (0.22–1.22)

 

 Malaria diagnosis

29/90 (32.2%)

18/33 (54.6%)

2.52 (1.12–5.71)

1.82 (1.05–3.13)

 Dehydration

3/90 (3.3%)

3/33 (9.1%)

2.90 (0.56–15.13)

 

 URTIa

20/90 (22.2%)

8/33 (24.2%)

1.12 (0.44–2.86)

 

 Dysentery

47/90 (52.2%)

8/33 (24.2%)

0.29 (0.12–0.72)

0.30 (0.07–1.24)

Treatment

 Concurrent ORSa

59/90 (65.6%)

14/33 (42.4%)

0.39 (0.17–0.88)

0.34 (0.10–1.19)

 Concurrent zinc

41/90 (45.6%)

15/33 (45.5%)

1.00 (0.45–2.22)

 
  1. aURTI Upper respiratory tract infection, ORS Oral rehydration solution
  2. bAdjusted by variables shown with adjusted OR and within-clinician variation
  3. Odd ratio in bold indicates p-value < 0.05