DOI: https://doi.org/10.36347/sjams.2025.v13i01.030

Pages: 187-194

Background: Acute respiratory infections (ARIs) are a primary cause of morbidity and mortality in children under five, particularly in low- and middle-income countries such as Bangladesh. Despite the viral nature of most ARIs, antibiotics are often prescribed, contributing to antibiotic resistance—a critical public health issue. Understanding the patterns and drivers of antibiotic use for ARIs in children is essential for developing strategies to combat misuse and resistance. Objective: This study aims to examine the prevalence and determinants of antibiotic use for ARIs among children under five in Bangladesh, assessing both healthcare provider and parental influences on prescribing practices. Methods: Using data from the 2014 Bangladesh Demographic and Health Survey (BDHS), we analyzed the antibiotic treatment patterns for ARIs in children under five. The survey utilized a two-stage cluster sampling method and included interviews with mothers to capture demographic, socioeconomic, and healthcare access information, as well as ARI symptoms and antibiotic use details. Statistical analyses were conducted to identify factors associated with antibiotic prescription. Results: Of 2,146 children under five with ARI symptoms, 38.7% received antibiotics. Antibiotic use was more prevalent in rural areas (41%) compared to urban settings (31.3%) and among children treated by unqualified practitioners (47.1%) rather than healthcare professionals (37.5%). Antibiotic prescriptions were influenced by parental education levels, geographic divisions, and healthcare access. Sources listed as "Others," which include alternative suppliers, showed the highest prevalence of antibiotic usage (76%). Factors like child malnutrition did not significantly impact antibiotic use, though severe wasting was associated with lower antibiotic prescriptions. Conclusion: This study highlights a high rate of antibiotic use for ARIs in children under five in Bangladesh, largely driven by ...