Descriptive Study on Parents’ Knowledge, Attitudes and Practices on Antibiotic Use and Misuse in Children with Upper Respiratory Tract Infections in Cyprus

Abstract

Upper respiratory tract infections (URTIs) are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents’ and pediatricians’ Knowledge, Attitude and Practices (KAP) concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462) follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p < 0.001). Pediatricians (N = 33) denied prescribing antibiotics after parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians’ view differs.

Knowledge and attitudes towards the use of antibiotics in the paediatric age group: a multicenter survey in Italy

“…Many studies highlighted a general lack of knowledge on the correct use of antibiotics by parents of paediatric age children. [10][11][12][13][14][15][16][17][18][19] This could lead to an inappropriate administration of antibiotics to children, given that from 10% to 60% of parents declare to administer antibiotics without medical prescription. [11][12][13]15,19 Moreover, several studies demonstrated that attitudes of parents could influence the decision of the paediatrician about the prescription of an antibiotic, making the lack of knowledge of the parents about this issue even more dangerous.…”

“…[11][12][13]15,19 Moreover, several studies demonstrated that attitudes of parents could influence the decision of the paediatrician about the prescription of an antibiotic, making the lack of knowledge of the parents about this issue even more dangerous. 14,20 To date no studies have evaluated knowledge and attitudes on antibiotics among parents of children aged between 0-14 years in Italy. It should be noted that in 2011, this Country had one of the highest consumption of antibiotics in Europe, preceded only by Greece, Cyprus, France and Luxembourg, with a consequent increased likelihood of inappropriate assumptions.…”

“…28 In a previous study on this topic conducted in Cyprus among parents of children between 4 and 7 years of age, 93% of the sample acknowledged that antibiotics have side effects and 87% that fever is not an indication for the administration of antibiotics. 14 In the general population, a recent meta-analysis of 24 observational studies showed how 50% of the sample stated that antibiotics are useful for cold and flu and 54% that antibiotics can treat viral infections. 29 A study on this topic in a sample of students of a School of medicine, gave, as expected, more promising results.…”

Shared decision making in primary care: barriers and facilitators of shared decision making in the context of decreasing the use of unnecessary antibiotics for preschool children ages 3-5 with upper respiratory tract infections

“…The unnecessary use of antibiotics is a worldwide public health issue (Alumran, Hou & Hurst, 2013;Lucas et al, 2015;Dwibedi et al, 2015;Kutty, 2011;Llor & Bjerrum, 2014;Rouusounides et al, 2011). There are multiple factors that cause concern regarding unnecessary antibiotic use, including complications related to antibiotic resistant bacteria, side effects of antibiotic use, and the possibility that antibiotics will become ineffective against bacteria.…”

“…Within the preschool population, unnecessary antibiotics are most commonly prescribed for viral upper respiratory infections (URIs) (Clavenna & Bonati, 2011;Kutty, 2011). Upper respiratory tract infections (URIs) include viral rhinitis (the common cold), influenza type A and B, acute viral rhinosinusitis, non-streptococcal tonsillitis, and pharyngitis (Boonacker et al, 2010;Rouusounides et al, 2011), and account for the highest number of emergency visits and the second highest number of primary care and outpatient visits in children (Touchie, 2013). Approximately 50% of total antibiotic prescriptions for preschool children are unnecessary, with 20% being attributed to URIs (Clavenna & Bonati, 2011;Maor et al, 2011).…”