ANTIBIOTIC MISUSE IN DIARRHEA - A HOUSEHOLD SURVEY IN A MEXICAN COMMUNITY

A survey of 1659 households in a periurban community in Mexico City wa s carried out to assess the frequency of and risk factors for inapprop riate antimicrobial therapy in acute diarrhea. The housewife was inter viewed to obtain information of the occurrence of diarrhea or use of a n antibiotic in the previous 2 weeks by any member of the family. An a ntibiotic was used in 37% or 287 diarrheal episodes although only in 5 % of all episodes was this therapy indicated, based on the presence of gross blood in stools. Patients seen by a physician were 6 times more likely to be treated with an antibiotic compared to those who did not consult a physician (p < 0.001). Self-medication was associated with a higher risk of using an inadequate drug or dose (in 72% of treated e pisodes) and of following treatment for less than 5 days (in 66% of tr eated episodes). Other risk factors significantly and independently as sociated with antibiotic misuse were: an increased number of stools (o dds ratio [OR] = 1.21; 95% confidence interval [CI] = 1.04, 1.41), blo ody diarrhea (OR = 19.04; 95% CI = 2.52, 160.90) and family crowding ( OR = 2.07; 95% CI = 1.17, 3.63). These findings support future communi ty-oriented educational interventions aimed at improving physician pre scribing practices and patient compliance behavior in order to achieve a more rational use of antibiotics.