Antibiotic use for upper respiratory tract infections in children: A cross-sectional survey of knowledge, attitudes, and practices (KAP) of parents in Greece

Abstract

BackgroundUpper respiratory tract infections (URTIs) are common in children. The cause of URTIs is usually viral, but parents' attitudes often contribute to inappropriate prescription of antibiotics, promoting antibiotic resistance. The objective of this study was to document and analyse parental beliefs on antibiotic use for children with URTIs in Greece, a country with high levels of antibiotic use and antibiotic resistance.MethodsA knowledge-attitude-practice questionnaire was developed and distributed to Greek parents caring for children who were 5-6 years old, between January and July of the same school year. The sample of the study contained parents from all geographic areas of Greece.ResultsThe majority of Greek parents (80%) believed that UTRIs are mostly self-limited, although 74% of them expected to receive antibiotics when such a diagnosis was given. Earache was the most common reason for which parents expected antibiotics (45%). Greek parents rarely gave antibiotics to their children without medical advice (10%) and most (88%) believed that unnecessary antibiotic use drives antibiotic resistance and they were happy to receive symptomatic therapy if instructed by their physician. Almost 70% of parents confused antibiotics with other medicines used for symptomatic therapy for a child with URTI.ConclusionGreek parents have a trusted relationship with their paediatrician and rarely give antibiotics without medical advice, indicating that parents contribute less than expected to antibiotic misuse. Parents also appreciate the benign course of most URTIs and the fact that unnecessary antibiotic use is harmful. More time needs to be invested in educating mostly physicians on the potential benefit from reducing antibiotic prescribing for children with URTI.

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.…”

Decrease of Antibiotic Consumption in Children with Upper Respiratory Tract Infections after Implementation of an Intervention Program in Cyprus

“…Factors leading to antimicrobial misuse in children are complex, involving both parental and physician beliefs as well as daily practice constraints (3,9,10). It is unclear whether the driving force of antibiotic misuse involves parental pressure or pediatricians' advice (9,13). The results of a comprehensive intervention program aiming to reduce antibiotic misuse in children with URTIs in Cyprus are described here.…”

Antibiotic utilisation amongst Australian Chinese migrants: a web-based bilingual health survey

“…As a result, the general public commonly has the perception that antibiotics are necessary and generally safe for symptoms of URTIs (50). Around three quarters of respondents from Putrajaya, Malaysia and parents in Greece expected antibiotics for treatment of coughs and cold (44,51). Close to 60%…”

“…Parents/caregivers' knowledge, attitudes and behaviours of antibiotic use were predictive factors to antibiotic misuse in children (51,65,85). A review of interventions to reduce inappropriate use of antibiotics in children concludes that delayed prescribing, providing guidance to parents on specific symptoms, and interventions engaging children prior to an illness episode would be most effective (86).…”

“…Greece and other countries (38,44,51,55,56,70). Questions were arranged and tailored for our study population.…”