{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:28:23Z","timestamp":1789201703458,"version":"build-2803163510"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T00:00:00Z","timestamp":1606003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1066764"],"award-info":[{"award-number":["OPP1066764"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Empirical antimicrobial use is common in hospitalized infants and may contribute to antimicrobial resistance in low- and middle-income countries. In this observational birth cohort study nested in a randomized controlled trial in Dhaka, Bangladesh, inpatient antimicrobial prescription data were extracted from serious adverse event forms completed for hospitalizations of infants (0\u201312\u2009months of age). The primary outcome was the proportion of inpatient admissions where systemic antimicrobials were prescribed. Infant and hospitalization-related factors associated with antimicrobial prescriptions were determined. Among 1254 infants, there were 448 admissions to 32 facilities from 2014 to 2016. Antimicrobials were prescribed in 73% of admissions with a mean antimicrobial exposure rate of 0.25 antimicrobials per day of admission [95% confidence intervals (95% CIs): 0.24\u20130.27]. The most common antibiotics were aminoglycosides (29%), penicillins (26%) and third-generation cephalosporins (25%). In all, 58% of antibiotics were classified as \u2018access\u2019, 38% \u2018watch\u2019 and 1% \u2018reserve\u2019 using the World Health Organization (WHO) Essential Medicines List classification. WHO-recommended antimicrobial regimens were used in 68% of neonatal sepsis and 9% of lower respiratory tract infection (LRTI) admissions. \u2018Watch\u2019 antimicrobials were used in 26% of neonatal sepsis and 76% of LRTI admissions. Compared with private facilities, antimicrobial prescription rates were lower at government [rate ratio (RR) 0.71; 95% CI: 0.61\u20130.83] and charitable facilities (RR 0.39; 95% CI: 0.28\u20130.53), after adjustment for household wealth index and parental education. Younger infant age, older maternal age and longer admission were associated with higher prescription rates. These findings highlight the need for paediatric antimicrobial stewardship programs in Bangladesh.<\/jats:p>","DOI":"10.1093\/tropej\/fmaa093","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T03:27:33Z","timestamp":1601522853000},"source":"Crossref","is-referenced-by-count":6,"title":["Antimicrobial Prescribing during Infant Hospital Admissions in a Birth Cohort in Dhaka, Bangladesh"],"prefix":"10.1093","volume":"67","author":[{"given":"Katherine","family":"Boone","sequence":"first","affiliation":[{"name":"Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON M5G 1X8, Canada"},{"name":"Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun K","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON M5G 1X8, Canada"},{"name":"Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada"},{"name":"Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sejal","family":"Doshi","sequence":"additional","affiliation":[{"name":"Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Black","sequence":"additional","affiliation":[{"name":"Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhazul","family":"Mohsin","sequence":"additional","affiliation":[{"name":"Nutrition and Clinical Services Division, icddr,b, Dhaka 1212, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahmeed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Nutrition and Clinical Services Division, icddr,b, Dhaka 1212, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Al Mahmud","sequence":"additional","affiliation":[{"name":"Nutrition and Clinical Services Division, icddr,b, Dhaka 1212, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON M5G 1X8, Canada"},{"name":"Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,22]]},"reference":[{"key":"2021072906203669400_fmaa093-B1","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/S1473-3099(05)70189-4","article-title":"Antimicrobial resistance in developing countries. 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