Table 1. Antibiotic treatment of moderate-to-severe diarrhea and less-severe diarrhea.
| Outcome | Measure | Setting | |||||||
|---|---|---|---|---|---|---|---|---|---|
| The Gambia | Mali | Mozambique | Kenya | India | Bangladesh | Pakistan |
All (excl. Kenya) |
||
| Ages 6 weeks to 11 months | |||||||||
| MSD with dysentery | |||||||||
| Total cases, N | 52 | 23 | 28 | 23 | 63 | 500 | 106 | 772 | |
| Administered or prescribed antibiotics, n (%) | 49 (94.2) | 22 (95.7) | 23 (82.1) | 23 (100) | 59 (86.5) | 497 (99.4) | 91 (85.8) | 741 (96.0) | |
| Administered antibiotics at health center, n (%) | 10 (19.2) | 8 (34.8) | 10 (35.7) | 4 (17.4) | 5 (7.9) | 51 (10.2) | 6 (5.7) | 90 (11.7) | |
| Prescribed antibiotics, administration unverified, n (%) | 39 (75.0) | 14 (60.9) | 13 (46.4) | 19 (82.6) | 54 (85.7) | 446 (89.2) | 85 (80.2) | 651 (84.3) | |
| MSD without dysentery | |||||||||
| Total cases, N | 472 | 938 | 411 | 806 | 815 | 172 | 682 | 3490 | |
| Administered or prescribed antibiotics, n (%) | 376 (79.7) | 869 (92.6) | 335 (81.5) | 574 (71.2) | 723 (88.7) | 137 (79.7) | 65 (9.5) | 2505 (71.8) | |
| Administered antibiotics at health center, n (%) | 135 (28.6) | 152 (16.2) | 270 (65.7) | 158 (19.6) | 164 (20.1) | 137 (79.7) | 15 (2.2) | 873 (25.0) | |
| Prescribed antibiotics, administration unverified, n (%) | 241 (51.1) | 717 (76.4) | 65 (15.8) | 416 (51.6) | 559 (68.6) | 0 (0.0) | 50 (7.3) | 1632 (46.8) | |
| LSD | |||||||||
| Total cases, N | 220 | 236 | 155 | – – | 213 | 183 | 227 | 1234 | |
| Administered or prescribed antibiotics, n (%) | 181 (82.3) | 197 (83.5) | 83 (53.5) | – – | 79 (37.1) | 110 (60.1) | 26 (11.5) | 676 (54.8) | |
| Administered antibiotics at health center, n (%) | 3 (1.4) | 6 (2.5) | 3 (1.9) | – – | 0 (0.0) | 0 (0.0) | 1 (0.4) | 13 (1.1) | |
| Prescribed antibiotics, administration unverified, n (%) | 178 (80.9) | 191 (80.9) | 80 (51.6) | – – | 79 (37.1) | 110 (60.1) | 25 (11.0) | 663 (53.7) | |
| Ages 12 to 23 months | |||||||||
| MSD with dysentery | |||||||||
| Total cases, N | 137 | 50 | 45 | 21 | 80 | 420 | 122 | 854 | |
| Administered or prescribed antibiotics, n (%) | 122 (89.1) | 49 (98.0) | 41 (91.1) | 20 (95.2) | 77 (96.2) | 418 (99.5) | 104 (85.2) | 811 (95.0) | |
| Administered antibiotics at health center, n (%) | 22 (16.1) | 10 (20.0) | 8 (17.8) | 6 (28.6) | 6 (7.5) | 75 (17.9) | 10 (8.2) | 131 (15.3) | |
| Prescribed antibiotics, administration unverified, n (%) | 100 (73.0) | 39 (78.0) | 33 (73.3) | 14 (66.7) | 71 (88.8) | 343 (81.7) | 94 (77.0) | 680 (79.6) | |
| MSD without dysentery | |||||||||
| Total cases, N | 477 | 861 | 193 | 470 | 672 | 159 | 390 | 2752 | |
| Administered or prescribed antibiotics, n (%) | 382 (80.1) | 805 (93.5) | 151 (78.2) | 342 (72.8) | 637 (94.8) | 122 (76.7) | 46 (11.8) | 2143 (77.9) | |
| Administered antibiotics at health center, n (%) | 132 (27.7) | 83 (9.6) | 125 (64.8) | 84 (17.9) | 143 (21.3) | 122 (76.7) | 8 (2.1) | 613 (22.3) | |
| Prescribed antibiotics, administration unverified, n (%) | 250 (52.4) | 722 (83.9) | 26 (13.5) | 258 (54.9) | 494 (73.5) | 0 (0.0) | 38 (9.7) | 1530 (55.6) | |
| LSD | |||||||||
| Total cases, N | 202 | 226 | 175 | – – | 180 | 148 | 171 | 1102 | |
| Administered or prescribed antibiotics, n (%) | 162 (80.2) | 196 (86.7) | 95 (54.3) | – – | 92 (51.1) | 96 (64.9) | 18 (10.5) | 659 (59.8) | |
| Administered antibiotics at health center, n (%) | 10 (5.0) | 4 (1.8) | 1 (0.6) | – – | 0 (0.0) | 0 (0.0) | 2 (1.2) | 17 (1.5) | |
| Prescribed antibiotics, administration unverified, n (%) | 152 (75.2) | 192 (85.0) | 94 (53.7) | – – | 92 (51.1) | 96 (64.9) | 16 (9.4) | 642 (58.3) | |
| Ages 24 to 59 months | |||||||||
| MSD with dysentery | |||||||||
| Total cases, N | 70 | 61 | 53 | 42 | 98 | 363 | 97 | 742 | |
| Administered or prescribed antibiotics, n (%) | 64 (91.4) | 57 (93.4) | 47 (88.7) | 39 (92.9) | 96 (98.0) | 361 (99.4) | 86 (88.7) | 711 (95.8) | |
| Administered antibiotics at health center, n (%) | 15 (21.4) | 7 (11.5) | 8 (15.1) | 10 (23.8) | 10 (10.2) | 94 (25.9) | 12 (12.4) | 146 (19.7) | |
| Prescribed antibiotics, administration unverified, n (%) | 49 (70.0) | 50 (82.0) | 39 (73.6) | 29 (69.0) | 86 (87.8) | 267 (73.6) | 74 (76.3) | 565 (76.1) | |
| MSD without dysentery | |||||||||
| Total cases, N | 173 | 784 | 84 | 416 | 379 | 100 | 201 | 1721 | |
| Administered or prescribed antibiotics, n (%) | 143 (82.7) | 731 (93.2) | 61 (72.6) | 302 (72.6) | 364 (96.0) | 76 (76.0) | 20 (10.0) | 1395 (81.1) | |
| Administered antibiotics at health center, n (%) | 43 (24.9) | 48 (6.1) | 46 (54.8) | 55 (13.2) | 2 (19.0) | 76 (76.0) | 4 (2.0) | 219 (12.7) | |
| Prescribed antibiotics, administration unverified, n (%) | 100 (57.8) | 683 (87.1) | 15 (17.9) | 247 (59.4) | 292 (77.0) | 0 (0.0) | 16 (8.0) | 1106 (64.3) | |
| LSD | |||||||||
| Total cases, N | 135 | 230 | 101 | – – | 181 | 83 | 108 | 838 | |
| Administered or prescribed antibiotics, n (%) | 113 (83.7) | 175 (76.1) | 53 (52.5) | – – | 108 (59.7) | 50 (60.2) | 10 (9.3) | 510 (60.9) | |
| Administered antibiotics at health center, n (%) | 4 (3.0) | 1 (0.4) | 5 (5.0) | – – | 0 (0.0) | 0 (0.0) | 0 (0.0) | 10 (1.2) | |
| Prescribed antibiotics, administration unverified, n (%) | 109 (80.7) | 174 (75.7) | 48 (47.5) | – – | 108 (59.7) | 50 (60.2) | 10 (93) | 499 (59.5) | |
MSD: Moderate-to-severe diarrhea; LSD: less-severe diarrhea
We indicate the number and proportion of children in each clinical category (dysenteric or non-dysenteric MSD; LSD) administered or prescribed antibiotics. We distinguish cases who were administered antibiotics at the healthcare center and those given an antibiotic prescription, among whom antibiotic administration was unverified. We present estimates stratified by the occurrence of additional, non-diarrhea diagnoses in S2 Table; cases diagnosed with pneumonia/lower respiratory-tract infection, meningitis or other invasive disease, and typhoid were excluded from our definition of clinically-attended, antibiotic-treated diarrhea, as these conditions would warrant antibiotic treatment regardless of diarrhea symptoms.