{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:47:42Z","timestamp":1787496462111,"version":"build-2736575974"},"reference-count":49,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The National Institutes of Health\/National Institute of Allergies and Infectious Diseases","award":["R01AI133080"],"award-info":[{"award-number":["R01AI133080"]}]},{"DOI":"10.13039\/100000865","name":"The Bill and Melinda Gates Foundation","doi-asserted-by":"crossref","award":["OPP1105094"],"award-info":[{"award-number":["OPP1105094"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>\n                    Pediatric community-acquired pneumonia (CAP) remains a pressing global health concern, particularly in low-resource settings where diagnosis and treatment rely on empiric, symptoms-based guidelines such as the WHO\u2019s Integrated Management of Childhood Illness (IMCI). This study details the delivery of IMCI-based health care to 1,320 young infants and their mothers in a low-resource urban community in Lusaka, Zambia during 2015. Our Southern Africa Mother Infant Pertussis Study (SAMIPS) prospectively monitored a cohort of mother\/infant pairs across infants\u2019 first four months of life, recording symptoms of respiratory infection and antibiotics prescriptions (predominantly penicillins), and tested nasopharyngeal (NP) samples for respiratory syncytial virus (RSV) and\n                    <jats:italic>Bordetella pertussis<\/jats:italic>\n                    . Our retrospective analysis of the SAMIPS cohort found that symptoms and antibiotics use were more common in infants (43% and 15.7%) than in mothers (16.6% and 8%), while RSV and\n                    <jats:italic>B. pertussis<\/jats:italic>\n                    were observed at similar rates in infants (2.7% and 32.5%) and mothers (2% and 35.5%), albeit frequently at very low levels. In infants, we observed strong associations between symptoms, pathogen detection, and antibiotics use. Critically, we demonstrate that non-macrolide antibiotics were commonly prescribed for pertussis infections, some of which persisted across many weeks. We speculate that improved diagnostic specificity and\/or clinician education paired with timely, appropriate treatment of pertussis could substantially reduce the burden of this disease while reducing the off-target use of penicillins.\n                  <\/jats:p>","DOI":"10.7717\/peerj.15175","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T04:58:25Z","timestamp":1683781105000},"page":"e15175","source":"Crossref","is-referenced-by-count":7,"title":["Young Zambian infants with symptomatic RSV and pertussis infections are frequently prescribed inappropriate antibiotics: a retrospective analysis"],"prefix":"10.7717","volume":"11","author":[{"given":"Christian E.","family":"Gunning","sequence":"first","affiliation":[{"name":"Odum School of Ecology, University of Georgia, Athens, GA, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pejman","family":"Rohani","sequence":"additional","affiliation":[{"name":"Odum School of Ecology, University of Georgia, Athens, GA, United States of America"},{"name":"Center for the Ecology of Infectious Diseases; Department of Infectious Diseases, University of Georgia,  Athens, GA, United States of America"},{"name":"Department of Infectious Diseases, University of Georgia, Athens, GA, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Mwananyanda","sequence":"additional","affiliation":[{"name":"School of Public Health, Department of Global Health, Boston University, Boston, MA,  United States of America"},{"name":"Right to Care Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Kwenda","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Department of Biomedical Science, University of Zambia, Lusaka, 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