Validation of the parental knowledge and attitude towards antibiotic usage and resistance among children in Tetovo, the Republic of Macedonia

Abstract

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.

A systematic review to explore influences on parental attitudes towards antibiotic prescribing in children

“…Eleven studies identified that in private healthcare systems, regular follow‐ups with clinicians either by phone or home/office visit were more common. Parents reported more satisfaction when they knew and trusted their clinician and felt the clinician knew their family (Al‐Dossari, ; Alili‐Idrizi et al., ; Alkhaldi et al., ; Brookes‐Howell et al., ; Cabral et al., ; Chinnasami et al., ; Ecker et al., ; Panagakou et al., ; Rousounidis et al., ; Salazar et al., ; Zyoud et al., ). However, in three of the studies, parents felt that the clinician did not know their child or discuss their child's health with them, resulting in a feeling of lack of trust in the clinician and reduced compliance from parents (Alkhaldi et al., , Dwibedi et al., ; Wun et al., ).…”

“…A dominant theme, identified in the majority of the studies, was the variation in parental knowledge, attitudes and practices on antibiotic use and misuse in children with upper respiratory tract infections (URTIs) (Agarwal et al., ; Al‐Dossari, ; Alili‐Idrizi et al., ; Alkhaldi et al., ; Brookes‐Howell et al., ; Chan & Tang, ; Chinnasami et al., ; Ecker et al., ; Farha, Suyagh, Alsakran, Alsous, & Alefishat, ; Finkelstein et al., ; Panagakou et al., ; Rousounidis et al., ; Salazar et al., ; Wun et al., ; Yu et al., ; Zyoud et al., ). In fifteen studies, the levels of education were cited as significant to parents' knowledge (Agarwal et al., ; Al‐Dossari, ; Alili‐Idrizi et al., ; Alkhaldi et al., ; Chan & Tang, ; Chinnasami et al., ; Dwibedi et al., ; Ecker et al., ; Farha et al., ; Panagakou et al., ; Rousounidis et al., ; Salazar et al., ; Salonga, ; Vaz et al., ; Yu et al., ). In four studies (Agarwal et al., ; Al‐Dossari, ; Ecker et al., ; Zyoud et al., ), parents could not generally identify or name an antibiotic and only two studies cited that parents had knowledge of the importance of completing antibiotic courses (Agarwal et al., ; Ecker et al., ).…”

“…Four studies conducted in Asia and the Middle East, respectively, identified that fathers usually had higher education levels (Agarwal et al., ; Alili‐Idrizi et al., ; Alkhaldi et al., ; Farha et al., ). This may have influenced decision‐making in the family as the mothers were often the main carers staying at home and therefore making most of the daily decisions for the children.…”

“…A common theme found in over half of the studies was that many parents did not know about possible antibiotic side effects (Agarwal et al., ; Al‐Dossari, ; Brookes‐Howell et al., ; Chinnasami et al., ; Ecker et al., ; Farha et al., ; Rousounidis et al., ; Salazar et al., ; Salonga, ; Wun et al., ; Zyoud et al., ), and in three studies, parents believed there were no side effects at all (Agarwal et al., ; Salonga, ; Wun et al., ). Although, in over half of the studies parents reported being aware of AMR, this did not seem to significantly influence their approach to using antibiotics (Alili‐Idrizi et al., ; Brookes‐Howell et al., ; Chinnasami et al., ; Ecker et al., ; Farha et al., ; Finkelstein et al., ; Panagakou et al., ; Rousounidis et al., ; Wun et al., ; Yu et al., ; Zyoud et al., ).…”

Mothers’ approach on the use of antibiotics in children: how effective is short information?

“…Ancak bizim sonuçlarımızdan farklı olarak bu çalışmalarda katılımcıların antibiyotik kullanımıyla ilgili bilgi düzeyleri annelerin yaş, eğitim durumu, sosyoekonomik durum ve yaşadığı bölgeyle ilişkili bulunmuştur. [13][14][15][16] Parimi ve ark. 'nın çalışmasında özel sağlık güvencesine sahip olmak, bilgi düzeyinin yüksek olması ile ilişkili bulunmuştur.…”