Opportunités manquées d’initiation d’un traitement antibiotique chez les enfants hospitalisés pour pneumonie sévère au Burkina Faso

Abstract

Background: Pneumonia, a leading cause of morbidity and mortality among children under five in Burkina Faso, requires hospitalisation and antibiotic therapy in severe cases according to WHO guidelines. This study aimed to estimate the proportion of missed opportunities to initiate antibiotic therapy (MOAT) on admission and to describe antibiotic prescriptions among children under five hospitalised with severe pneumonia.

Methods: A cross-sectional study was conducted from August 30, 2021, to January 31, 2024, at Banfora Regional Hospital, including children under five hospitalised with severe pneumonia. MOAT was defined as the absence of antibiotic initiation on admission. Factors associated with MOAT were identified using logistic regression.

Results: Of the 1410 children included, 32% (449/1410) had MOAT. Compared to those aged 2–5 months, children aged 6–11 months (aOR=1.71; 95% CI: 1.13–2.57) and 24–59 months (aOR=1.62; 95% CI: 1.12–2.33) had a higher risk of MOAT. Persistent vomiting (aOR=1.38; 95% CI: 1.07–1.77), impaired consciousness (aOR=1.52; 95% CI: 1.11–2.07), and chest indrawing (aOR=1.33; 95% CI: 1.05–1.69) were also associated with an increased risk. Among the 961 children who received antibiotic therapy, ceftriaxone (77.4%; 744/961), classified as “Watch”, and gentamicin (59.0%; 567/961), classified as “Access” according to the WHO AWaRe classification, were the most commonly administered.

Conclusion: MOAT and inappropriate prescribing practices were common among children hospitalized for severe pneumonia in Burkina Faso. Strengthening adherence to WHO clinical guidelines is essential to ensure appropriate care and reduce the risk of antimicrobial resistance.