Defiance On the Implementation of WHO-guidelines: Antibiotic Use in under Five Years Children with Acute Gastroenteritis in District Hospital

Abstract

Background: According to WHO guidelines, antibiotic should not be used for acute gastroenteritis in children unless there is accompanying bacterial infections. Irrational use of antibiotics contributes to bacterial drug resistance, adverse drug reactions and unnecessary cost. There are few studies in Africa that examined the effects of using antibiotics among children under five years old with acute gastroenteritis.  This study aimed to describe rational use of antibiotherapy among children under five years with acute gastroenteritis at Remera Rukoma District Hospital. Methods: This study was prospective descriptive using a structured questionnaire to collect data. The study’s participants were the files of children under five years diagnosed with acute gastroenteritis who visited Remera Rukoma District Hospital from 1st February 2023 to 28th February 2024. A total 110 patients’ e-files met the criteria from 253 patients attended the facility suffering from gastroenteritis, and data were analyzed using SPSS version 26.0. The study compared the irrational and rational use of among under five years children suffering from gastroenteritis. Results: This study found that a high percentage of laboratory investigations (70%) were performed after initiation of a treatment. The comparison of irrational and rational use of antibiotics showed that irrational use of antibiotics was 3.54 times higher the rational use. The majority of patients were suffering from watery diarrhea and the frequency of irrational use of antibiotics was also high in this group. Conclusion:   The rate of irrational use of antibiotics in under fiveyear children was more than three times higher than rational use of antibiotics. Recommendation: The institution should train the health professionals to adhere to the guidelines and frequent auditing the diagnosing and treatment process of this vulnerable population. The management should monitor the effects of this defiance leading to drug resistance.