Dynamics of Antibiotic Prescription, Self-Medication and Bacterial Resistance in the Pediatric Population: A Multidimensional Study of Public and Private Health Centers in the Province of Chincha

This comprehensive technical report presents an in-depth analysis of the pharmacological management of Acute Respiratory Infections (ARIs) in the pediatric population of Chincha Province, Ica Department, Peru. The research examines the operational and clinical dichotomy between public sector facilities (Ministry of Health - MINSA and Social Security Health Insurance - EsSalud) and private healthcare infrastructure (clinics, polyclinics, and medical centers), evaluating prescribing patterns, adherence to national and international Clinical Practice Guidelines (CPGs), and the impact of self-medication facilitated by pharmacies. The findings reveal a silent but growing public health crisis. While the public sector struggles with adherence to protocols due to overcrowded healthcare facilities and limitations in rapid microbiological diagnostic tools, the private sector shows a trend toward overprescribing broad-spectrum antibiotics (third-generation cephalosporins and macrolides), driven by implicit economic incentives and the cultural demand for a "quick cure" from parents. We documented alarming rates of self-medication in districts such as Sunampe and Grocio Prado, exceeding 88%, and a sustained increase in bacterial resistance, particularly in Escherichia strains. Extended-Spectrum Beta-lactamase (ESBL) -producing coli and Staphylococcus methicillin -resistant aureus (MRSA), exacerbated after the COVID-19 pandemic. This report proposes a roadmap for regulatory and educational intervention, essential to preserving therapeutic efficacy in the region.