Antibiotics Self Medication among Children: A Systematic Review

Abstract

The phenomenon of bacterial antimicrobial resistance (AMR) is a rapidly growing global problem. Overuse and misuse of antibiotics as well as self-prescription are among the most important causes contributing to the growth of antibiotic resistance in humans. This systematic review describes the phenomenon of antibiotics self-medication (ASM) in children. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist by searching PubMed, Scopus, and Web of Science until July 2022. Published English language studies containing information regarding parents knowledge, attitudes, and behaviors in self-administration of antibiotics in children were included. A total of 702 articles were identified, and 57 were selected. A higher prevalence of ASM among children was found in the Middle-East (34%), Africa (22%), Asia (20%) and South America (17%), while the lowest prevalence was found in Europe (8%). High distance from hospital, and low income, such as having more than one child, are related with an increased risk of ASM in children. Fever and cough can also promote the misuse of antibiotics by parents. A greater attention to the regulation of the sale of antimicrobial drugs can certainly limit the risk of self-medicating behavior.

Insights into Parental Behavior: Self-Medication Patterns with antibiotics for Child Health

“…Parents of <30 years, doing service, having postgraduate degree, having Ayushman card, and having family member working in medical field were seen keeping antibiotic stock at home for later use. A systematic review 4 revealed that around 40%, ranging from 12% to 80.5% parents believed that leftover antibiotics in the past can be used to treat their children. This was statistically associated with higher risk of antibiotic self medication with an odds ratio of 3.01.…”

“…3 A meta-analysis with 57 studies indicated that the prevalence of SMA among children was 24% worldwide, with higher prevalence in the Middle East at 34%, Africa 22%, Asia 20%, and South America at 17%, while the lower prevalence in Europe at 8%. 4 The prescribing patterns of antibiotics are not well controlled in many countries especially the developing ones which emphasizes the need to investigate and tackle such unhealthy practices. 5 As there are fewer studies on self-medication with antibiotics in children in India, we aim to assess the behavior of parents on self-medicating children with antibiotics.…”

Prevalence and Predictors of Using Antibiotics without a Prescription in a Pediatric Population in the United States

“…In a recent systematic review, the prevalence rate of antibiotic self-medication among children was highest in studies conducted in the Middle East (34%), while the lowest prevalence was found in Europe (8%) [ 27 ]. An additional finding from this systematic review was that only two studies, one conducted in Tanzania and the other in Jordan, reported parent age as statistically significant, but the results were mixed [ 27 ]. In the first study completed in Tanzania, researchers found that parents younger than 40 tended to administer more antibiotics without consulting a physician [ 27 ].…”

“…An additional finding from this systematic review was that only two studies, one conducted in Tanzania and the other in Jordan, reported parent age as statistically significant, but the results were mixed [ 27 ]. In the first study completed in Tanzania, researchers found that parents younger than 40 tended to administer more antibiotics without consulting a physician [ 27 ]. On the contrary, in a study from Jordan, parents older than 40 were more inclined to self-medicate their children with antibiotics [ 27 ].…”

“…In the first study completed in Tanzania, researchers found that parents younger than 40 tended to administer more antibiotics without consulting a physician [ 27 ]. On the contrary, in a study from Jordan, parents older than 40 were more inclined to self-medicate their children with antibiotics [ 27 ]. However, our findings align with previous studies in the U.S. that identified younger adults as having a higher propensity to use non-prescribed antibiotics [ 11 , 28 ].…”