“I don’t hesitate to use the left-over antibiotics for my child” practices and experiences with antibiotic use among caregivers of paediatric patients at Zomba central hospital in Malawi

Abstract

Background Inappropriate use of antibiotics is among the major causes of the global emergency of antibiotic resistance among children. The problem of inappropriate use of antibiotics among children is of special concern because they are still developing immunological systems, hence they are susceptible to many infectious diseases. As such, they receive a considerable disproportional amount of antibiotics which exposes them to antibiotic resistance. This study explored the lived experiences of caregivers of children under the age of five years on the use of antibiotics at Zomba central hospital. Objective The main aim of this study was to explore the lived experiences of caregivers of children under the age of five years on antibiotic usage at Zomba Central Hospital, Zomba-Malawi. Methodology This was a descriptive qualitative study with a phenomenological approach to explore the lived experience of caregivers of paediatric patients on antibiotic usage from May 2019 to July 2020. The study used interview guides to conduct in-depth interviews with 16 caregivers and purposive sampling was used to select the participants from the children’s ward. All interviews were audio-recorded and qualitative data was transcribed verbatim and thematically analysed manually to extract major themes and concepts on the subject matter. Results Caregivers had little knowledge about antibiotic use and its resistance. most caregivers use the antibiotics inappropriately through self-medication, use of left-over antibiotics, buying antibiotics without prescription, and sharing of antibiotics. Conclusion Based on the findings of this study, investment in public awareness and organising community-led interventions in antibiotic use related information is key to improve the quality use of antibiotics. The Government should focus on promoting interventions that lessen the indiscriminate use of antibiotics among the caregivers. Stringent laws need to be enforced by the government to restrict the access of antibiotics to parents without a prescription.

What influences parental decisions about antibiotic use with their children: A qualitative study in rural Australia

“…Parents may also act on the advice of people in their social network about when to consult the health system and for antibiotic-related decisions, such as decisions about using leftovers. This is consistent with international study findings where parents who live in resource limited settings obtain advice about antibiotics from friends and relatives [ 18 , 22 ].…”

“…Our findings are consistent with international studies that parents may use leftover antibiotics to treat alike or reoccurring symptoms in their children [ 7 , 22 ] and reuse antibiotics between siblings/other children [ 4 , 8 ]. Use of non-prescription antibiotics in children has also been associated with economic constraints [ 1 , 17 ] and poor access to healthcare [ 16 , 18 – 20 ].…”

“…Access to health care is often challenged in rural and remote locations [ 21 ], a contextual variable likely to affect parental decisions about meeting the health care needs of their children [ 19 ]. Parents have also been found to make decisions about their children’s antibiotic use based on advice from their social group or support network [ 1 , 11 , 18 , 22 ].…”

“…However, there is an absence of theory informed research when examining parental perceptions about their children's antibiotic use [11,12,[22][23][24]. Studies that have used qualitative methods have primarily been concentrated in Europe, the United States, Asia and Africa [22,[25][26][27][28][29].…”

Knowledge, attitudes and behaviour of Egyptians towards antibiotic use in the community: can we do better?

“…Research from around the globe indicates high rates of injudicious use of antibiotics by the public. Practices related to injudicious use in the literature include the use of left over antibiotics [ 6 , 7 ] and antibiotic non-adherence usually due to remission of symptoms [ 8 ]. Further, the pressure made by patients who request antibiotics from clinicians has been shown to be one of the factors driving unwarranted provision of antibiotics by clinicians such as physicians [ 9 ] and pharmacists [ 10 ].…”