Healthcare seeking behavior and antibiotic use for diarrhea among children in rural Bangladesh before seeking care at a healthcare facility

Abstract Appropriate healthcare utilization and compliance with the WHO treatment guidelines can significantly reduce diarrhea-related childhood mortality and morbidity, while overuse of antibiotics notably increases antibiotic resistance. We studied care-seeking behavior and antibiotic use for chil...

Full description

Saved in:
Bibliographic Details
Main Authors: Sampa Dash, Mohammad Ali, Eva Sultana, Malathi Ram, Jamie Perin, Farina Naz, Bharati Roy, ABM Ali Hasan, Farzana Afroze, Fahmida Tofail, Tahmeed Ahmed, ASG Faruque, Subhra Chakraborty
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-09479-w
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Appropriate healthcare utilization and compliance with the WHO treatment guidelines can significantly reduce diarrhea-related childhood mortality and morbidity, while overuse of antibiotics notably increases antibiotic resistance. We studied care-seeking behavior and antibiotic use for childhood diarrhea by analyzing data from 8294 diarrheal episodes of 1–59-month-old children visiting a tertiary-care hospital in rural Bangladesh. Overall, 55% of the study children received antibiotics, while only 6% had dysentery. Notably, 77% of the antibiotics were obtained from a local pharmacy without a prescription. Antibiotics alone, without zinc or ORS, were used by more children with dysentery than watery diarrhea (15% vs. 9%; p < 0.001). While 85% of the children received ORS, only 7% received zinc and ORS without antibiotics. Children who received antibiotics before seeking care at the hospital had a significantly higher rate of hospitalization than those who did not have antibiotics (20% vs. 13%; p < 0.001). The factors that influenced the caregivers’ decision to seek care from the pharmacy were the desire for early recovery, traditional practices, faith in seeking care at pharmacies, and distance to a healthcare facility. Our findings warrant that reducing unnecessary antibiotic consumption requires increasing public awareness and strengthening laws on the sale of over-the-counter antibiotics.
ISSN:2045-2322