Management of children admitted to hospitals across Bangladesh with suspected or confirmed COVID-19 and the implications for the future: a nationwide cross-sectional study

Kona Chowdhury, Mainul Haque, Nadia Nusrat, Nihad Adnan, Salequl Islam, Afzalunnessa Binte Lutfor, Dilara Begum, Arif Rabbany, Enamul Karim, Abdul Malek, Nasim Jahan, Jesmine Akter, Sumala Ashraf, Mohammad Hasan, Mahmuda Hassan, Najnin Akhter, Monika Mazumder, Nazmus Sihan, Nurun Naher, Shaheen AkterSifat Zaman, Tanjina Chowdhury, Jebun Nesa, Susmita Biswas, Mohammod Islam, Al Mamun Hossain, Habibur Rahman, Palash Kumar Biswas, Mohammed Shaheen, Farah Chowdhury, Santosh Kumar, Amanj Kurdi, Zia Ul Mustafa, Natalie Schellack, Marshall Gowere, Johanna C. Meyer, Sylvia Opanga, Brian Godman

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There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO 'Watch' list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.
Original languageEnglish
Article number105
Number of pages18
Issue number1
Early online date14 Jan 2022
Publication statusPublished - 14 Jan 2022


  • antibiotics
  • antimicrobial stewardship programs
  • Bangladesh
  • children
  • COVID-19
  • guidelines
  • hospitals
  • outcomes

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