The rate of antibiotic utilization in Iranian under 5-year-old children with acute respiratory tract illness: A nationwide community-based study

Nasser Mostafavi, Arash Rashidian, Akram Karimi-Shahanjarini, Ardeshir Khosravi, Roya Kelishadi


Background: To investigate the prevalence of antibiotic usage in children aged <5 years with acute respiratory tract illness (ARTI)
in Iran. Materials and Methods: Data were collected from a national health survey conducted in 2010 (Iran’s Multiple Indicator Demographic and Health Survey). Participants of this cross-sectional study were selected by multistage stratifi ed cluster-random sampling from 31 provinces of Iran. Parents of children with <5 years of age responded to questions about the occurrence of any cough during the previous 2 weeks, referral to private/governmental/other health care systems, and utilization of any oral/injection form of antibiotics. Data were analyzed using SPSS software18. Th e chi-square test was used to determine antibiotic consumption in various gender and residency groups and also a place of residence with the referral health care system. Results: Of the 9345 children under 5 years who participated in the study, 1506 cases (16.2%) had ARTI during 2 weeks prior to the interview, in whom 1143 (75.9%) were referred to urban or rural health care centers (43.4 vs. 30.4%; P < 0.001). Antibiotics were utilized by 715 (62.6%) of aff ected children.Injection formulations were used for 150 (13.1%) patients. Th e frequency of receiving antibiotics was higher in urban than in rural inhabitants (66.0% vs. 57.7%; P < 0.05). Conclusion: Th e prevalence of total and injection antibiotics usage in children <5 years with ARTI is alarmingly high in Iran. Th erefore, interventions to reduce antibiotic use are urgently needed.

Key words: Anti-bacterial agents, child, Iran, respiratory tract diseases, utilization

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