Fever in children under five years of age is a common and predominantly self-limiting sign of illness. However, in low- and middle-income countries, antibiotics are frequently used in febrile children, although these children may not benefit from antibiotics. In this study, we explored the prevalence of, and factors associated with, antibiotic use in children under five years old with febrile illness in Bangladesh. We analysed data from the 2017–2018 Bangladesh Demographic and Health Survey to determine the prevalence of antibiotic use in children under five years of age with a febrile illness. We used a causal graph and performed a multivariable logistical regression to identify the factors associated with antibiotic use in children under five years old with febrile illness in Bangladesh. Of the 2784 children aged less than five years with fever included in our analysis, 478 (17%, 95% CI 15% to 19%) received antibiotics. Unqualified sources, including unqualified providers and pharmacies, contributed to 60% of antibiotic prescriptions in children with fever, followed by the private medical sector (29%) and the public sector (23%). The highest use of antibiotics was found in children under six months of age (25%). Children with parents who completed secondary or higher education were more likely to receive antibiotics (adjusted OR (aOR): 2.61 (95% CI 1.63 to 4.16)) than children whose parents did not complete primary education. Educational interventions promoting rational use of antibiotics and improved regulations governing over the counter purchase of antibiotics in Bangladesh may improve antibiotic dispensing practices.

中文翻译：

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孟加拉国 5 岁以下儿童使用抗生素治疗发热性疾病：一项具有全国代表性的抽样调查

五岁以下儿童发烧是一种常见且主要是自限性疾病的征兆。然而，在低收入和中等收入国家，发热儿童经常使用抗生素，尽管这些儿童可能无法从抗生素中获益。在这项研究中，我们探讨了孟加拉国 5 岁以下发热性疾病儿童使用抗生素的流行率和相关因素。我们分析了 2017-2018 年孟加拉国人口与健康调查的数据，以确定 5 岁以下发热性疾病儿童的抗生素使用率。我们使用因果图并执行多变量逻辑回归来确定与孟加拉国 5 岁以下发热性疾病儿童使用抗生素相关的因素。在我们的分析中包括的 2784 名 5 岁以下发烧儿童中，478 名（17%，95% CI 15% 至 19%）接受了抗生素治疗。不合格的来源，包括不合格的提供者和药房，占发烧儿童抗生素处方的 60%，其次是私营医疗部门 (29%) 和公共部门 (23%)。六个月以下的儿童使用抗生素最多（25%）。与父母未完成初等教育的儿童相比，父母完成中学或高等教育的儿童更有可能接受抗生素治疗（调整后 OR (aOR)：2.61（95% CI 1.63 至 4.16））。促进合理使用抗生素的教育干预措施和改进孟加拉国抗生素柜台购买的法规可能会改善抗生素配药做法。