A review on antimicrobial agents in pediatrics in Bangladesh: synthetic methods and antimicrobial resistance challenges

Abstract

Antimicrobial drugs are important in managing pediatric infections in Bangladesh. However, their misuse has contributed significantly to the rising issue of antimicrobial resistance (AMR). This review examines frequently utilized antimicrobial agents in pediatric patients in Bangladesh, focusing on their usage patterns, synthetic methodologies, and challenges related to resistance. Ciprofloxacin, azithromycin, metronidazole, ceftriaxone, and amikacin are some of the most common antibiotics. An analysis of selected articles shows that ciprofloxacin (24.1-27.9%) and metronidazole (24.5-27.8%) are the most often used antibiotics among children aged 24-59 months, followed by azithromycin (19-45%). Alarmingly, significant antibiotic usage was reported in non-bloody diarrhea. Cefixime and other cephalosporins were used in only around 1-2% of cases. Most widely utilized agents are synthetic or semi-synthetic medicines that have been chemically modified to improve efficacy and stability. Following this, the excessive and inappropriate use of broad-spectrum antibiotics in pediatric patients has significantly contributed to the emergence of antimicrobial resistance in Bangladesh.