Prevalence and factors related to antibiotic prescription in Benin: A school-based study

Rational use of antibiotics in poor-resource settings countries is challenging. In order to assess the factors related to antibiotic prescription, a cross sectional study was carried out in four school infirmaries from February to June 2008 in the district of Allada in Benin. For each patient, socio-demographic characteristics, symptoms motivating medical visits, diagnosis and therapeutic prescriptions were collected. A malaria rapid diagnostic test was used in case of fever. Data were entered and validated with Epidata® software, and analysed with STATA 11® software. One thousand six hundred and thirty medical visits occurred during the study period. Fever was reported by 57% of children. Malaria was the leading diagnosis (32%), followed by respiratory infection (17.5%). Antibiotic was prescribed to 40% of the children. Respiratory infection and skin disorders were positively related to antibiotic usage [OR = 59.5 (33.4–105.7); P < 10−3 and OR = 6.4 (4.6–8.8); P < 10−3 respectively]. Malaria [OR = 0.11 (0.03–0.11); P < 10−3] and fever of unknown origin [OR = 0.05 (0.03–0.11); P < 10−3] were negatively related to antibiotic usage. Further clinical surveys and trials aimed at rationalizing antibiotics usage in this area should focus on the management of acute respiratory illnesses.