Determinants of trends in reported antibiotic use among sick children under five years of age across low-income and middle-income countries in 2005–17: A systematic analysis of user characteristics based on 132 national surveys from 73 countries

ObjectivesThis study aimed to analyze any reported antibiotic use for children aged <5 years with fever, diarrhea or cough fast difficult breathing (outcome) from low-income and middle-income countries (LMICs) during 2005–2017 by user characteristics: rural/urban residence, maternal education, household wealth, healthcare source visited.MethodsBased on 132 demographic health surveys multiple indicator cluster 73 LMICs, the outcome characteristics all country-years was estimated using a hierarchical Bayesian linear regression model.ResultsAcross LMICs 2005–2017, greatest relative increases in occurred rural areas, poorest quintiles least educated populations, particularly South-East Asia. In countries, areas had 72% increase 17.8% (Uncertainty Interval (UI): 5.2%–44.9%) 2005 30.6% (11.7%–62.1%) 2017, compared 29% urban 27.1% (8.7%–58.2%) 34.9% (13.3%–67.3%) 2017. Despite these increases, consistently highest wealthiest quintiles, populations education.ConclusionThese estimates suggest that increasing sick driven gains among groups often underserved formal services.