Prevalence and associated factors to antibiotic self-medication in children with diarrhea and cough/fever in Peru

Alvarez Romani A.P.; Quezada Gamboa D.A.; Peláez Chávez J.D. · Andes Pediatrica (2026) · DOI: 10.32641/andespediatr.v97i5.5967

Resumen

Worldwide, between 35% and 50% of children are self-medicated with antibiotics (SMA). Pa-tient-related factors, the family and cultural environment, the illness, and access to the health care system influence SMA. Objective: To determine the prevalence and factors associated with SMA in children < 5 years with fever/cough and diarrhea. Patients and Method: Cross-sectional study using data from the 2024 Demographic and Family Health Survey (ENDES), representative of Peru. Two groups were analyzed: children with cough/fever symptoms (CFS) and children with diarrhea (CD) during the previous two weeks. We estimated the prevalence of SMA and analyzed associated factors using negative binomial regression with a log link (adjusted prevalence ratio: aPR). Results: We included 19,820 children. Among the CD group (n = 2,394), 31.2% were aged 12–23 months and 27.0% lived in the jungle; whereas among the CFS group (n = 7,635), 21.7% were aged 12–23 months and 20.4% lived in the jungle. SMA affected 9.2% of CFS, 6.0% of CD, and 13.4% of those with both conditions. The absence of child health check-ups increased the probability of SMA [CFS (aPR: 1.47; 95%CI: 1.20–1.81) and CD (aPR: 1.55; 95%CI: 1.01–2.40)]. According to the symptom group, the region of residence was associated [Sierra in CFS (aPR: 1.55; 95% CI: 1.11–2.16) and the rest of the coast in CD (aPR: 5.95; 95% CI: 1.26–28.07)]. Conclusions: SMA in children < 5 years is prevalent, especially among those with overlapping symptoms. Associated factors varied according to the child’s symptom, with lack of health check-ups being the only factor associated with higher SMA in both groups.

Instituciones: Universidad de Piura