Article Sidebar

Download
PDF (Français (Canada))
Statistic
Read Counter : 0 Download : 0

Downloads

Download data is not yet available.

Main Article Content

Abstract

Introduction. Inappropriate antibiotic use is a major driver of antimicrobial resistance, particularly concerning in resource-limited settings where therapeutic options are constrained. In the Democratic Republic of Congo, data on prescribing rationality in pediatrics are scarce. This study aimed to assess antibiotic use in pediatric wards in Butembo and to identify factors associated with prescribing that adheres to WHO recommendations (AWaRe classification). Methods. We conducted a retrospective analytical study from July 1, 2022 to June 30, 2023 in six hospitals in Butembo, including 1,077 children aged 0 to 15 years. Sampling was random and stratified by health zone and facility. Data were extracted from medical records. The dependent variable was adherence to the ACCESS category of the AWaRe classification. Binary logistic regressions (backward stepwise method) identified associated factors, with significance set at p < 0.05. Results. Infectious diagnoses accounted for 66.2% of hospitalizations. Among children who received antibiotics (90.7%), the antibiotic was not indicated in 52.0% of cases, was first-line in 45.6%, and belonged to the WHO ACCESS category in 41.6%. The mean number of antibiotics administered per patient was 2.05. In multivariate analysis, the religious affiliation of the facility (OR Catholic vs Protestant = 0.046; 95% CI: 0.02-0.11; p < 0.001) and the number of antibiotics administered (OR = 1.30; 95% CI: 1.04-1.63; p = 0.024) were significantly associated with adherence to AWaRe recommendations. Conclusion. Antibiotic use in pediatric wards in Butembo is characterized by a high proportion of non-indicated prescriptions (52%) and low use of ACCESS antibiotics (42%). Targeted interventions, including prescriber training and strengthening antibiotic stewardship programs, are needed to improve prescribing rationality, particularly in Protestant-affiliated facilities where the risk of non-adherence is higher.

Keywords

Antibiotics, rational prescribing, AWaRe, pediatrics, Butembo, DRC, antimicrobial resistance Antibiotiques, prescription rationnelle, AWaRe, pédiatrie, Butembo, RDC, antibiorésistance

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite
Kambale Mastaki Jérome, Kanyamanda Paluku Jean, Ngwala Ngwala Blaise, Mutume Kabila Thierry, Kamabu Jean Louis, Kambale Kalungero Gervais, … Kavira Zawadi Myrtha. (2026). Antibiotic Use in Pediatric Wards of Hospitals in the City of Butembo, Democratic Republic of Congo: Utilisation des Antibiotiques en Pédiatrie à Butembo (RDC) : Évaluation de la Rationalité des Prescriptions selon la Classification AWaRe de l’OMS. HEALTH SCIENCES AND DISEASE, 27(8), 46–54. https://doi.org/10.67260/hsd.v27i8.7827
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Horgan J. Théorie Microbienne [Internet]. World History Encyclopedia. 2023. Available from: https://www.worldhistory.org/trans/fr/1-22085/theorie-microbienne/.).
  2. 2. Sansonetti P, Orth G. Maîtrise des maladies infectieuses. EDP Sciences ; 2012.
  3. 3. Werth BJ. Présentation des antibiotiques [Internet]. Manuels MSD pour le grand public. Manuels MSD ; 2022. Available from: https://www.msdmanuals.com/fr/accueil/infections/antibiotiques/pr%C3%A9sentation-des-antibiotiques.
  4. 4. Antibiotic Classification [Internet]. Microbiologie-clinique.com. 2026 [cited 2026 Apr 21]. Available from: https://microbiologie-clinique.com/en/antibiotic-classification.html?utm_content=cmp-true.
  5. 5. Accueil | Anses - Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail [Internet]. Anses.fr. 2024 [cited 2026 Apr 21]. Available from: https://www.anses.fr/fr/.
  6. 6. Abubakar U, Salman M. Antibiotic Use Among Hospitalized Patients in Africa : A Systematic Review of Point Prevalence Studies. Journal of Racial and Ethnic Health Disparities. 2023 May 8.
  7. 7. Mengistie Yirsaw Gobezie, Tesfaye NA, Faris AG, Hassen M. Surveillance of antimicrobial utilization in Africa : a systematic review and meta-analysis of prescription rates, indications, and quality of use from point prevalence surveys. Antimicrobial Resistance and Infection Control. 2024 Sep 11 ;13(1).
  8. 8. Okedo-Alex IN, Akamike IC, Iyamu I, Umeokonkwo CD. Pattern of antimicrobial prescription in Africa : a systematic review of point prevalence surveys. The Pan African Medical Journal [Internet]. 2023 [cited 2024 Apr 16] ;45 :67. Available from: https://pubmed.ncbi.nlm.nih.gov/37637407/.
  9. 9. Prescriptions inappropriées [Internet]. Sante.fr. 2024 [cited 2026 Apr 21]. Available from: https://www.omedit-grand-est.ars.sante.fr/prescriptions-inappropriees.
  10. 10. Guo S, Sun Q, Zhao X, Shen L, Zhen X. Prevalence and risk factors for antibiotic utilization in Chinese children. BMC Pediatrics [Internet]. 2021 Jun 1 [cited 2023 May 5] ;21(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8168021/.
  11. 11. Jose S, Rajashekarachar Y, S.P. B, Naidu B. Evaluation of antibiotic usage on lower respiratory tract infections in paediatric department- an observational study. International Journal of Contemporary Pediatrics. 2016 ;146–9.
  12. 12. Les défis du bon usage des antibiotiques [Internet]. Msf.org. 2023 [cited 2026 Apr 21]. Available from: https://epicentre.msf.org/actualites/les-defis-du-bon-usage-des-antibiotiques.
  13. 13. Hedible GB, Besnier C, Neboua D, Gres E, Kargougou DG, Sawadogo GA, et al. Facteurs associés aux sur-prescriptions d’antibiotiques lors des consultations de prise en charge intégrée des maladies de l’enfant (PCIME) chez les enfants âgés de 2 à 59 mois dans les centres de santé primaire. Projet AIRE (Burkina Faso, Guinée, Mali) 2021-2022. Revue d’Épidémiologie et de Santé Publique. 2023 Sep ;71 :101889.
  14. 14. Sana B, Kaboré A, Hien H, Zoungrana BE, Meda N. Etude de l’utilisation des médicaments chez les enfants dans un contexte de gratuité des soins. Pan African Medical Journal. 2019 Dec 12 ; 34.
  15. 15. Haque M. Antibiotic Use, Antibiotic Resistance, and Anti Stewardship – A Global Public Consequences. Bangladesh Journal of Medical Science. 2019 Mar 25 ;18(2) :169–70.
  16. 16. CDC. Antibiotic Use and Antimicrobial Resistance Facts [Internet]. Antibiotic Prescribing and Use. 2024. Available from: https://www.cdc.gov/antibiotic-use/data-research/facts-stats/index.html.
  17. 17. World. Résistance aux antimicrobiens [Internet]. Who.int. World Health Organization : WHO ; 2019 [cited 2026 Apr 21]. Available from: https://www.who.int/fr/health-topics/antimicrobial-resistance.
  18. 18. Pédiatrie Archives de Guide de prescription d’antibiotique en pédiatrie [Internet]. [cited 2026 Apr 21]. Available from: https://www.sfmu.org/upload/consensus/arcped_gpip_15_juin_new_couv_bs.pdf.
  19. 19. The WHO AWaRe (Access, Watch, Reserve) antibiotic book [Internet]. www.who.int. 2022. Available from: https://www.who.int/publications/i/item/9789240062382.
  20. 20. Antimicrobial resistance in the African Region : Issues, challenges and actions proposed [Internet]. Available from: https://www.afro.who.int/sites/default/files/2017-06/amr-paper-march-2013-jbn-and-all.pdf.
  21. 21. Publié par Centres Africains de Contrôle et de Prevention des Maladies Le Centre pour la dynamique Économie et Politique des maladies Lignes directrices africaines sur le traitement antibiotique des infections et des syndromes bactériens courants [Internet]. [cited 2026 Apr 21]. Available from: https://africaguidelines.onehealthtrust.org/wp-content/uploads/2021/11/Guidelines_French.pdf.
  22. 22. Contributeurs aux projets Wikimedia. Ville de la République démocratique du Congo [Internet]. Wikipedia.org. Fondation Wikimedia, Inc. ; 2005 [cited 2026 Apr 21]. Available from: https://fr.wikipedia.org/wiki/Butembo.
  23. 23. Accueil - DHIS2 [Internet]. DHIS2. 2025 [cited 2026 Apr 21]. Available from: https://dhis2.org/fr/.
  24. 24. Serhier Z, Bendahhou K, Ben Abdelaziz A, Othmani M, Maghrébin R. Fiche Méthodologique n°1 : Comment calculer la taille d’un échantillon pour une étude observationnelle ? Methodological sheet n°1: How to calculate the size of a sample for an observational study? [Internet]. Available from: https://applications.emro.who.int/imemrf/455/Tunisie-Med-2020-98-1-1-7-fre.pdf.
  25. 25. Calculator.net. Random Number Generator [Internet]. www.calculator.net. 2008. Available from: https://www.calculator.net/random-number-generator.html.
  26. 26. Télécharger et installer ou réinstaller Office 2021, Office 2019 ou Office 2016 - Support Microsoft [Internet]. Microsoft.com. 2021 [cited 2026 Apr 21]. Available from: https://support.microsoft.com/fr-fr/office/t%C3%A9l%C3%A9charger-et-installer-ou-r%C3%A9installer-office-2021-office-2019-ou-office-2016-7c695b06-6d1a-4917-809c-98ce43f86479.
  27. 27. Advanced multiprocessing capabilities [Internet]. www.stata.com. Available from: https://www.stata.com/statamp/.
  28. 28. Origas M. L’histoire de la santé humaine : de ses débuts à ses nouveaux défis ! [Internet]. Futura. 2021 [cited 2026 May 5]. Available from: https://www.futura-sciences.com/sciences/actualites/epoque-contemporaine-histoire-sante-humaine-debuts-nouveaux-defis-92166/.
  29. 29.vision, stratégies et initiatives spéciales [Internet]. 2023 [cited 2026 May 5]. Available from: https://www.afro.who.int/sites/default/files/2023-09/Ending%20disease%20in%20Africa_ENDISA_FR_0.pdf.;
  30. 30.Antibiotiques : quand les bactéries font de la résistance [Internet]. Institut Pasteur. 2018. Available from: https://www.pasteur.fr/fr/journal-recherche/dossiers/antibiotiques-quand-bacteries-font-resistance.
  31. 31.Tattevin P. Importance du bon usage des antibiotiques dans les pays à ressources limitées. Médecine et Maladies Infectieuses Formation [Internet]. 2026 ;5(1) : S26. Available from: http://dx.doi.org/10.1016/j.mmifmc.2025.12.060.
  32. 32.The Global Burden of Disease: Main Findings for Sub-Saharan Africa [Internet]. World Bank. 2013. Available from: https://www.worldbank.org/en/region/afr/publication/global-burden-of-disease-findings-for-sub-saharan-africa;
  33. 33.Orish VN. Economic Burden of Infectious Diseases and Benefit of Control and Prevention in Sub-Saharan Africa. OALib. 2015 ;02(12) :1–6.
  34. 34.Keny YGS, Salifou K, Gontran LY, Renaud KKG, Kevin AJ, Famoussa K, et al. Overview of infectious diseases in the internal medicine department of the bouaké university hospital center (UHC) (Côte d’Ivoire). Open J Intern Med [Internet]. 2026 ;16(01) :76–83. Available from: http://dx.doi.org/10.4236/ojim.2026.161008).
  35. 35.Icyishatse O, Semukunzi H, Habarugira F, Njunwa KJ, Hahirwa I, Nyandwi JB. Rational use of antibiotics among inpatients at a University Teaching Hospital of Butare, in Rwanda : A cross-sectional study [Internet]. medRxiv. 2026. Available from: http://dx.doi.org/10.64898/2026.01.06.26343560.
  36. 36.Okedo-Alex IN, Akamike IC, Iyamu I, Umeokonkwo CD. Pattern of antimicrobial prescription in Africa : a systematic review of point prevalence surveys. Pan Afr Med J [Internet]. 2023 ;45 :67. Available from: http://dx.doi.org/10.11604/pamj.2023.45.67.36191.
  37. 37.Ekuma A, Onukak A, Udoette S, Versporten A, Pauwels I, Oduyebo O, et al. AWaRe classification of antibiotics prescribed within 2018-2021 for hospitalised medical and surgical patients in Uyo, Nigeria. Pan Afr Med J [Internet]. 2023 ;46 :80. Available from: http://dx.doi.org/10.11604/pamj.2023.46.80.33027.
  38. 38.Nsojo A, George L, Mwasomola D, Tawete J, Mbotwa CH, Mweya CN, et al. Prescribing patterns of antimicrobials according to the WHO AWaRe classification at a tertiary referral hospital in the southern highlands of Tanzania. Infect Prev Pract [Internet]. 2024 ;6(2) :100347. Available from: http://dx.doi.org/10.1016/j.infpip.2024.100347.
  39. 39. Les défis du bon usage des antibiotiques [Internet]. Msf.org. 2023. Available from: https://epicentre.msf.org/actualites/les-defis-du-bon-usage-des-antibiotiques.
  40. 40. Xavier SP, da Silva AMC, Victor A. Antibiotic prescribing patterns in pediatric patients using the WHO access, watch, reserve (AWaRe) classification at a quaternary hospital in Nampula, Mozambique. Sci Rep [Internet]. 2024 ;14(1) :22719. Available from: http://dx.doi.org/10.1038/s41598-024-72349-4.