Objective:This study sought to explore the knowledge and attitudes of parents on the use of antibiotics among children that could serve as baseline data and provide further insight in planning and developing strategies for local health education purposes.Methods:A cross-sectional survey involving 500 parents who attended community pharmacies in Tetovo, Republic of Macedonia, was conducted using a self-administered questionnaire from October 2013 to January 2014. The questionnaire included demographics, knowledge and attitude statements of parents towards antibiotics. The data collected were analyzed using SPSS program, version 19.0. Descriptive statistics was used to summarize the data. In all statistical analyses, a p-value of <0.05 was considered statistically significant.Results:Nearly 40% of the parents demonstrated a moderate level of knowledge. The highest correct response in the knowledge part was the awareness of parents in using antibiotics to treat a bacterial infection (61.2%). However, most of the parents did not know that antibiotics cannot cure viral infections (59.6%). About 48.2% of the parents were aware of the antibiotic resistance as s result of the overuse. Concerning attitudes, 60.8% reported keeping any leftover antibiotics, 77.0% agreed that taking antibiotics when having cold symptoms could help their children recover faster, while, 74.6% wrongly agreed with the statement of appropriate use of antibiotics for prophylaxis’ measure.Conclusions:This study has documented the main areas that merit attention when parental knowledge on antibiotic use for their children is the concern, reflecting in some inappropriate attitudes as well. The findings highlight the need to devise effective interventions to decrease misconceptions regarding antibiotic use and to increase parents’ awareness for the risks of inappropriate use of antibiotics in children specifically and in the community at large.

Background and Aims: Antibiotics play a major role in the treatment of infectious diseases and are among the drugs most commonly prescribed for children. Respiratory tract infections in pediatric patients are a common cause of antibiotic prescribing which increases morbidity, mortality, patient cost and the likelihood for emergence of antibiotics-resistant microorganisms. This study was undertaken to determine the proportion of common respiratory tract infections and to generate data on the extent of rational/irrational prescribing of antibiotics in patients attending the pediatric out-patient department. Material and Methods: retrospective study carried out during one year (January to December, 2013) in the pediatric out-patient department of the Clinical Center in Tetovo. Patients of either sex at age group between 1 week and 14 years who attended the pediatric out-patient department and were prescribed antibiotics for respiratory tract infections were included in the study. The data was compared against national guideline-based medicine, major antibiotic guidelines recommended by World Health Organization (WHO) and American Academy of Pediatrics (AAP), and cross-referenced against Cochrane studies. Results: Children aged >1 -≤3 years received 49.6% of antibiotics. The most common prescribed antibiotics were penicillins (62.2%), followed by cephalosporins (32.5%). Sore throat (61.5%) was identified as the most common diagnosis. There was a significant relationship (r=0.234, p< 0.05) between diagnosis and antibiotic prescribing. Ninety two percent of pediatric patients with common cold, laryngitis, viral sore throat, acute otitis media and bronchitis were prescribed antibiotics irrationally, that represents a major deviation from the recommendations from the guidelines. High levels (90%) of antibiotic irrational prescribing were revealed in pediatric outpatients diagnosed with pneumonia. Conclusion: This study reinforces the need to implement strategies that promote rational use of antibiotics in respiratory tract infections in children and close monitoring of antibacterial use at national, regional and local level.

Environmental exposure to lead is considered to be one of the most important hazards to the health of children. Most commonly exposed are those who are poor and live in developing countries. The environmental lead pollution problem in the Roma Mahala neighborhood of Mitrovica was discovered through the appearance of high blood lead levels (BLLs) in children living there. The aim of our study was to investigate the BLLs in children according to gender, age, and area of residence. This study describes the results from a 7-year retrospective study (January 2010–April 2017) based on BLLs conducted on children aged 0 to 13 years living in all three districts of Mitrovica. The survey included 331 children. Blood lead analysis was performed in the laboratory using capillary and venipuncture samples tested by anodic stripping voltammetry using LeadCare II machines. Mean BLLs were the highest in the Roma Mahala with 23.6 mg/dL (standard deviation ± 15.9 µg/dL). We obtained a statistical significance (p < 0.0001) between BLLs according to the settlements. The mean BLLs was higher in the 3 to 4 years aged children group in comparison with other age groups (p = 0.009). In none of the age groups with the Mann–Whitney test we obtained a significant gender difference on BLL (p > 0.05). Lead poisoning levels continue to be a serious problem among children living in Mitrovica over the past several years due to heavy lead pollution. All children from this region should receive environmental evaluations and medical examinations.

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