Drug use and abuse in childhood diarrhoeal diseases by caregivers reporting to a Nigerian tertiary health institution

Abstract

Background:
Childhood diarrhoeal diseases have great impact on morbidity and mortality. Early and appropriate interventions reverse the inherent dangers. However, the place of antibiotics treatment remains undefined considering the difficulties in establishing the role of bacterial agents in causation of diarrhea among children. Anti-motility drugs could be rather more harmful than useful.
Objectives:
To evaluate the practice of mothers/caregivers with respect to use of antibacterial and anti-motility drugs for under-five (U5) children with diarrhoeal diseases
Methods:
Caregivers of under-five children presenting to different Paediatrics clinics/wards of University of Nigeria Teaching Hospital (U.N.T.H.), Enugu between October 2006 and February 2007 were interviewed with a structured questionnaire. Among several details obtained include perception of cause of diarrhea, use of ORT fluids, and use of antibacterial and anti-motility drugs.
Result:
Caregivers of 156 under-five children with diagnosis of acute diarrhoea met the inclusion criteria and were recruited. There was a high level of use of both antibacterial and anti-motility agents even when they were not clearly indicated. Drug abuse was not influenced by perceived causes of diarrhoea nor did maternal educational level or socioeconomic status have any impact. Drug use negatively affected time of presentation to hospital and hydration status at presentation.
Conclusion:
Indiscriminate use of drugs for acute diarrhoea should be discouraged, while zinc supplements should be incorporated with regular monitoring of usage rates of ORT/Zinc supplements. Tighter regulation on accessibility of over-the-counter antibiotics to forestall the rapidly growing antibiotic resistance is highly indicated.