study of outpatient children in five waves of covid-19: comparing clinical manifestations, need for hospitalization, and antibiotic prescription

Background: the sars-cov-2 virus has shown various subtypes with unique characteristics, but the recurrence of covid-19 in children and the use of antibiotics for secondary bacterial infections have not been thoroughly investigated. objectives: this study aimed to analyze the frequency of covid-19 infections in children and the prescription of antibiotics for secondary bacterial infections in pediatric outpatient cases. methods: this cross-sectional study was conducted at three outpatient centers from february 2020 to august 2022. it included children under 15 years old with complete medical records related to sars-cov-2 infection. the study assessed clinical symptoms, hospitalization needs, antibiotic prescriptions, and the number of covid-19 episodes. results: out of 2,448 children diagnosed with covid-19, 65% were male. a total of 192 children (7.84%) had two episodes, 35 (1.43%) had three episodes, 7 (0.29%) had four episodes, and 2 (0.14%) had five episodes. 143 children (5.84%) required hospitalization. antibiotics were prescribed in 17.73% of cases (n = 434), primarily for acute bacterial sinusitis (12.21%) and middle ear infections (8.52%). common antibiotics included azithromycin, amoxicillin, cefuroxime, and co-trimoxazole. conclusions: different subtypes of sars-cov-2 display distinct clinical behaviors in the pediatric population. children can contract covid-19 multiple × however, antibiotic use in outpatient settings is relatively low and mainly associated with specific conditions, such as acute sinusitis and middle ear infections.