Parental knowledge, attitudes and practices regarding antibiotic use for acute upper respiratory tract infections in children: a cross-sectional study in Palestine

Abstract

BackgroundIn primary health care centres, upper respiratory tract infections (URTIs) in children are commonly encountered by physicians. Viruses cause most URTIs, but parents’ attitudes often represent an important reason for antibiotic abuse, which leads to the development and spread of antimicrobial resistance. The goal of this study was to examine parents’ knowledge, attitudes, and practices (KAP) about antibiotic use for children with URTIs in Palestine.MethodsA cross-sectional study was performed in primary health care centres in Nablus city from 1 June to 31 October 2012. A questionnaire was developed and administered to determine parents’ KAP regarding antibiotic use for their children with URTIs.ResultsThree hundred and eighty-five parents completed the questionnaire. A total of 79.7 % of the parents were attentive to the truth that antibiotic misuse is responsible for bacterial resistance. Only 18.9 % of parents thought that antibiotics did not have any harmful side effects. Fifty nine per cent of parents did not agree that URTIs are mostly viral in origin and are self-limited. Almost 73 % of parents choose antibiotics as a treatment for URTIs, while earache (68 %) and fever (64 %) were the most common reasons for which parents expected antibiotics. However, more than 38 % of the parents never asked the paediatrician to prescribe antibiotics, and only 6 % congratulated their paediatricians for not prescribing antibiotics.ConclusionsAlthough there is a trusted relationship between parents and paediatricians, Palestinian parents have insufficient knowledge related to antibiotic use for URTIs in children, which results in inappropriate attitudes and practices. Educational interventions for both parents and physicians will reduce unnecessary antibiotic use and resistance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-015-0494-5) contains supplementary material, which is available to authorized users.

Parents’ Expectations and Experiences of Antibiotics for Acute Respiratory Infections in Primary Care

“…Our findings are largely in line with those of previous studies on parental beliefs about antibiotics' benefits for acute respiratory infections, [18][19][20][21][22][23][24][25][26] although our study is among the first to quantify them. Of course, such expectations were not homogeneous across parents and illnesses-parents knew that not using antibiotics is sometimes acceptable, consistent with previous findings.…”

“…27,28 About one-half of parents reported antibiotic resistance as a potential harm, similar to proportions found in other cross-sectional studies, 21,28,29 although there was confusion among many about what resistance actually was, as has been reported by others. 18,25,29 Fewer parents mentioned common antibiotic harms consistent with empirical evidence, such as diarrhea and candidiasis 30 , and some of the complications that parents nominated as being reduced by antibiotic use are not clearly supported by evidence from randomized trials. Parents reported widespread use of alternatives to antibiotics in line with previous findings, 18,23 most of which have no or weak empirical evidence of efficacy, 31,32 with the exceptions being analgesics and antipyretics, and honey for cough.…”

“…18,25,29 Fewer parents mentioned common antibiotic harms consistent with empirical evidence, such as diarrhea and candidiasis 30 , and some of the complications that parents nominated as being reduced by antibiotic use are not clearly supported by evidence from randomized trials. Parents reported widespread use of alternatives to antibiotics in line with previous findings, 18,23 most of which have no or weak empirical evidence of efficacy, 31,32 with the exceptions being analgesics and antipyretics, and honey for cough. 33 Antibiotic use for acute respiratory infections is usually a decision that is sensitive to patient preference 34 because the benefit-harm trade-off is marginal.…”

The Assessment of Knowledge, Attitude and Practice of Antibiotics Usage Among Saudi Female Students in Princess Nourah University (Pnu)

“…In our study, 76.4% of PNU students used antibiotics prescribed by doctor while small percentage (3.1%) consumed antibiotics preparation available at home. Another study in Palestine by Zyoud et al, 2015, showed that only 18.9 % of parents thought that antibiotics did not have any harmful side effects. In our study, 77.2% of PNU students disagreed that it is allowed to stop using antibiotics if its harm and benefit equals while22.8% agreed with that idea.…”

Antibiotics Use and Misuse in Upper Respiratory Tract Infection Patients: Knowledge, Attitude and Practice Analysis in University Hospital, Saudi Arabia.

“…Both bacteriological and viral microorganisms are etiological factors contributing to the development of upper respiratory tract infections 1 . However, most of them are caused by viruses, in which antibiotics are not needed 2,3,4 . Respiratory system conditionsare the most common cause for antibiotics prescription 5,6 .Several studies showed that physicians practice in prescribing antibiotics in such cases could be related to the physician response to the patient pressure 7,8,9 .In addition, over-prescription practices have been attributed to vague diagnosis and the fear of inadequate level of health care.Antibiotics misuse in cases where no definite clinical benefits from them can lead to adverse effects 10,11,12 .…”