A cross-sectional study of antibiotic misuse among Chinese children in developed and less developed provinces

Abstract

Introduction: Antimicrobial resistance is a global health crisis and primarily caused by antibiotic misuse. Antibiotic misuse among children is particularly concerning, and its prevalence may vary from region to region in China with different development levels.
 Methodology: Zhejiang and Shaanxi were selected to represent developed and less developed provinces in China, respectively. Data of 2924 parents in Zhejiang and 3355 parents in Shaanxi whose children were 0-13 years old were collected through multi-stage stratified cluster random sampling and a self-administrated questionnaire. Chi-square tests and logistic regression models were used for statistical analysis.
 Results: Compared to parents in Zhejiang, those in Shaanxi were more likely to keep antibiotics for children at home, to engage in self-medication with antibiotics for children, and to make their children take antibiotics prophylactically. While there were no significant provincial differences between parents’ requests for antibiotics during pediatric consultations, parents in Shaanxi province were more likely to receive prescribed antibiotics.
 Conclusions: Children in less developed provinces face higher risks of antibiotic misuse at home as well as when attending medical practitioners. Comprehensive educational interventions are required to improve antibiotic use for children all over China but particularly in less developed provinces such as Shaanxi. Furthermore, non-prescription sales and over-prescribing of antibiotics should be reduced by targeted strategies.

The General Population’s Inappropriate Behaviors and Misunderstanding of Antibiotic Use in China: A Systematic Review and Meta-Analysis

“…In the current study, the general population refers to patients and people that are potential patients, for example, residents, the elderly, parents, etc. Prophylactic use of antibiotics refers to the behavior of people taking antibiotics to prevent common infectious diseases, such as the cold or flu, which are mainly non-indicated diseases [ 33 ].…”

Factors influencing inappropriate use of antibiotics in outpatient and community settings in China: a mixed-methods systematic review

“…The likelihood of being prescribed with antibiotics for presumed self-limiting illnesses during an outpatient clinic visit varied from 53.3% 13 to 94.5% 14 in mainland China and 17 to about 50% 18 of participants prescribed with antibiotics were administered them through intravenous infusion. [17][18][19] Six studies investigated how patients' socioeconomic backgrounds might influence antibiotic prescribing 13 14 17 20-22 and among them, two identified patients' antibiotics-related knowledge as a determinant.…”

Non-prescriptionxx antibiotic use for people aged 15 years or older for cough in China: a community-based survey

“…Previous studies [ 15 , 16 ] have also shown the non-prescription antibiotic rates at community pharmacies for adult acute URTI without population-based data. In addition, the previous population-based surveys only limited to university students [ 14 , 17 ] or children [ 18 ]. These studies have highlighted the seriousness of the non-prescribed and injudicious use of antibiotics, as well as high rate of antibiotic use for cough.…”