Management of children admitted to hospitals across Bangladesh with suspected or confirmed COVID-19 and the implications for the future : a nationwide cross-sectional study

Chowdhury, Kona and Haque, Mainul and Nusrat, Nadia and Adnan, Nihad and Islam, Salequl and Lutfor, Afzalunnessa Binte and Begum, Dilara and Rabbany, Arif and Karim, Enamul and Malek, Abdul and Jahan, Nasim and Akter, Jesmine and Ashraf, Sumala and Hasan, Mohammad and Hassan, Mahmuda and Akhter, Najnin and Mazumder, Monika and Sihan, Nazmus and Naher, Nurun and Akter, Shaheen and Zaman, Sifat and Chowdhury, Tanjina and Nesa, Jebun and Biswas, Susmita and Islam, Mohammod and Hossain, Al Mamun and Rahman, Habibur and Biswas, Palash Kumar and Shaheen, Mohammed and Chowdhury, Farah and Kumar, Santosh and Kurdi, Amanj and Mustafa, Zia Ul and Schellack, Natalie and Gowere, Marshall and Meyer, Johanna C. and Opanga, Sylvia and Godman, Brian (2022) Management of children admitted to hospitals across Bangladesh with suspected or confirmed COVID-19 and the implications for the future : a nationwide cross-sectional study. Antibiotics, 11 (1). 105. ISSN 2079-6382 (https://doi.org/10.3390/antibiotics11010105)

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Abstract

There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO 'Watch' list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.

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