{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:55:57Z","timestamp":1766051757637,"version":"3.48.0"},"reference-count":29,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: The inappropriate and empirical use of antibiotics in early childhood remains a major global public health concern, contributing significantly to the rise of antimicrobial resistance (AMR). In Kosovo, the COVID-19 pandemic further influenced prescribing behaviors in primary care, increasing the reliance on symptom-based treatment in the absence of laboratory confirmation and age-appropriate formulations. Aim: This study aimed to assess the prevalence and patterns of antibiotic prescribing among children aged 1\u20137 years in primary health care centers in Prishtina and Ferizaj from January 2022 to December 2025, and to compare regional differences in prescribing practices and guideline adherence. Methods: A retrospective observational study was conducted using data from the national electronic health record system and protocol books. All pediatric visits for children aged 1\u20137 years with infectious diagnoses were included. Descriptive statistics, Chi-square tests, and multivariable logistic regression were used to evaluate prescribing prevalence, demographic and seasonal variations, and independent predictors of antibiotic use, including assessment of appropriateness based on international pediatric guidelines. Results: Of 4320 pediatric visits, 1328 (30.7%) resulted in an antibiotic prescription. Prescribing prevalence was higher in Ferizaj (34.2%) than in Prishtina (28.5%, p &lt; 0.01). Amoxicillin\u2013clavulanic acid (42.9%) and amoxicillin (21.5%) were the most frequently prescribed agents, while macrolides (11.7% vs. 6.2%) and cephalosporins (7.9% vs. 3.4%) were more common in Ferizaj. Only 61.4% of prescriptions were fully guideline-concordant. Younger age (1\u20133 years), winter season, and residence in Ferizaj were independently associated with higher odds of receiving an antibiotic. Conclusions: Pediatric antibiotic prescribing in Kosovo remains high and predominantly empirical, reflecting real-world limitations in diagnostic capacity and formulation availability. Significant proportions of partially appropriate and inappropriate prescriptions highlight the need for standardized pediatric guidelines, improved diagnostic support, and strengthened stewardship initiatives within primary care.<\/jats:p>","DOI":"10.3390\/antibiotics14121282","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:15:21Z","timestamp":1766049321000},"page":"1282","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Patterns of Antibiotic Prescribing Among Children Aged 1\u20137 Years in Primary Health Care Centers in Prishtina and Ferizaj, Kosovo (2022\u20132025): A Retrospective Observational Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3827-4563","authenticated-orcid":false,"given":"Fitim Bexhet","family":"Alidema","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Faculty of Pharmacy, UBT College, 10000 Prishtina, Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arieta","family":"Hasani Alidema","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Medical, UBT College, 10000 Prishtina, Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4666-3232","authenticated-orcid":false,"given":"Lirim Shefki","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Pharmacy, UBT College, 10000 Prishtina, Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirlinda","family":"Havolli","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fellenza","family":"Abazi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2020). 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