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Antibiotics are frequently prescribed for the treatment of acute lower respiratory infections (ALRI) in children ≤5 years of age, even though viral aetiologies are the most common. The aim of this study was to describe antibiotic prescribing rates and patterns in children ≤5 years of age hospitalized with ALRI. A retrospective study was conducted involving patients aged 1 month to 5 years hospitalized with ALRI at a university hospital. Patient demographics, ALRI diagnosis, microbiological data, antibiotics prescribed, and treatment outcomes were recorded and analysed. A total of 1283 patients were enrolled. Their median age was 1.6 years (interquartile range 0.8-2.8 years). Thirty-six percent had a co-morbidity. The diagnosis at discharge was viral ALRI in 81% and bacterial pneumonia in 19%. The mortality rate was 0.4%. The overall antibiotic prescribing rate was 46% (95% confidence interval 43-49%). Antibiotic prescribing rates were higher among children with co-morbidities (65% vs 35%, p < 0.001) and older children (57% for >2-5 years vs 39% for ≤2 years, p < 0.001). Parenteral third-generation cephalosporins were prescribed in up to 68% of all prescriptions. Nearly-half of hospitalized children with ALRI were prescribed antibiotics. The majority of prescribed antibiotics were third-generation cephalosporins. An antimicrobial stewardship programme and antibiotic guidelines should be implemented to promote the judicious use of antibiotics. Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.


Noppadol Wacharachaisurapol, Nattapong Jitrungruengnij, Pakpoom Janewongwirot, Pintip Suchartlikitwong, Sineenart Chautrakarn, Watsamon Jantarabenjakul, Suvaporn Anugulruengkitt, Tuangtip Theerawit, Jiratchaya Sophonphan, Jitladda Deerojanawong, Chitsanu Pancharoen, Thanyawee Puthanakit. High prescribing rates of third-generation cephalosporins in children hospitalized with acute lower respiratory infections at a university hospital. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2021 Jan;102:369-374

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PMID: 33186703

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