{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:29:15Z","timestamp":1770744555439,"version":"3.49.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T00:00:00Z","timestamp":1656028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["47075"],"award-info":[{"award-number":["47075"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases of the Johns Hopkins School of Medicine","award":["10POS2015"],"award-info":[{"award-number":["10POS2015"]}]},{"name":"FONDECYT-CONCYTEC","award":["246-2015-FONDECYT"],"award-info":[{"award-number":["246-2015-FONDECYT"]}]},{"name":"National Institutes of Health Fogarty Global Health Fellows Consortium comprised of Johns Hopkins University"},{"DOI":"10.13039\/100006808","name":"University of North Carolina","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006808","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Morehouse University"},{"DOI":"10.13039\/100007875","name":"Tulane University","doi-asserted-by":"crossref","award":["D43TW009340"],"award-info":[{"award-number":["D43TW009340"]}],"id":[{"id":"10.13039\/100007875","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Department of Internal Medicine of the University of Virginia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There is a need to evaluate antibiotic use, duration of therapy, and stewardship in low- and middle-income countries to guide the development of appropriate stewardship programs that are global in scope and effectively decrease unnecessary antibiotic use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We prospectively collected information on illness occurrence and antibiotic use from a cohort of 303 children. We evaluated the incidence, duration of therapy, and appropriateness of antibiotic prescriptions by 5 main antibiotic prescribers (physicians and nurses, pharmacists, nursing assistants, self-prescriptions, and neighbors or family members).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ninety percent of children received an antibiotic during follow-up, and on average, by the end of follow-up a child had spent 4.3% of their first 5 years of life on antibiotics. The most frequent prescribers were physicians\/nurses (79.4%), followed by pharmacists (8.1%), self-prescriptions (6.8%), nursing assistants (3.7%), and family or neighbors (1.9%). Of the 3702 courses of antibiotics prescribed, 30.9% were done so for the occurrence of fever, 25.3% for diarrhea, 2.8% for acute lower respiratory disease, 2.7% for dysentery, and 38.2% for an undetermined illness. Courses exceeding the recommended duration were common for the principal diseases for which treatment was initiated, with 27.3% of courses exceeding the recommended length duration, representing a potential reduction in 13.2% of days on which this cohort spent on antibiotics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Stewardship programs should target medical personnel for a primary care stewardship program even in a context in which antibiotics are available to the public with little or no restrictions and appropriate duration should be emphasized in this training.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac500","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T14:50:44Z","timestamp":1656082244000},"page":"e1054-e1061","source":"Crossref","is-referenced-by-count":5,"title":["Antibiotic Use and Stewardship Practices in a Pediatric Community-based Cohort Study in Peru: Shorter Would be Sweeter"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5796-5116","authenticated-orcid":false,"given":"Francesca","family":"Schiaffino","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, Virginia , USA"},{"name":"Faculty of Veterinary Medicine, Universidad Peruana Cayetano Heredia , Lima , Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josh M","family":"Colston","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, Virginia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maribel","family":"Paredes Olortegui","sequence":"additional","affiliation":[{"name":"Asociacion Benefica Prisma, Iquitos, Loreto , Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Rengifo Pinedo","sequence":"additional","affiliation":[{"name":"Asociacion Benefica Prisma, Iquitos, Loreto , Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo","family":"Zamora Babilonia","sequence":"additional","affiliation":[{"name":"Asociacion Benefica Prisma, Iquitos, Loreto , Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar","family":"Ramal Asayag","sequence":"additional","affiliation":[{"name":"Hospital Regional de Loreto, Gobierno Regional de Loreto , Iquitos, Loreto , Peru"},{"name":"Faculty of Human Medicine, Universidad Nacional de la Amazonia Peruana , Iquitos, Loreto , Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Pe\u00f1ataro Yori","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, Virginia , USA"},{"name":"Asociacion Benefica Prisma, Iquitos, Loreto , Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret N","family":"Kosek","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, Virginia , USA"},{"name":"Asociacion Benefica Prisma, Iquitos, Loreto , Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"key":"2023020817080474400_ciac500-B1","volume-title":"Global action plan on antimicrobial resistance","author":"World Health Organization","year":"2015"},{"key":"2023020817080474400_ciac500-B2","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis","volume":"399","author":"Antimicrobial Resistance 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