Knowledge of pharmacists and parents towards antibiotic use in pediatrics: a cross-sectional study in Lebanon

Abstract

Objectives:to assess the knowledge of both parents and community pharmacists regarding antibiotics use and resistance in pediatrics in Lebanon.Methods:A cross-sectional study was conducted between June and August 2017 in community pharmacies. A pre-established questionnaire targeting knowledge of parents and pharmacists regarding antibiotics use/misuse was carried out. An index of knowledge was computed to assess factors associated with good knowledge on antibiotics use/misuse.Results:The study showed that 28.7% of pharmacists did not know which factors may contribute to antimicrobial resistance. Concerning the misuse of antibiotics, pharmacists blamed at first parents (90.1%), at second level physicians (72.8%), and third themselves (59.4%). Furthermore, pharmacists believed that the socioeconomic problems of the country (86.1%), the level of resistance to the molecule of choice (80.8%), the lack of consultation time (71.2%) and the lack of national guidelines/recommendations (66.3%) might be additional factors contributing to antimicrobial resistance. In case of acute otitis media, the majority of pharmacists chose the correct treatment, dose and duration according to international guidelines; this was in contrast to the results obtained in case of pharyngitis. Female pharmacists had a significantly higher knowledge score compared to their male counterparts (ORa=2.51). Half of parents (42.6%) declared that antibiotics act against both viruses and bacteria, 55.9% still believe that the presence of fever requires the administration of antibiotics, 50% didn’t know the consequences of antibiotics misuse, 58.4% said that it is okay to give their child antibiotics without a physician’s advice or based on a pharmacist’s recommendation, and 66.7% trusted the pharmacist in the antibiotic prescription. Parents with a university level of education or a master’s degree had significantly better knowledge compared to illiterate ones (ORa=9.04 and ORa=16.46, respectively).Conclusions:Based on the results obtained, it would be necessary to implement educational campaigns in order to increase awareness on antibiotics misuse and resistance in pediatrics.

A Survey of Pediatricians’ Views and Practices Regarding Parents’ Request for Prescribing Antibiotics: A Qualitative Study

“…The reasons for this difference may be as follows: working hours, close relationship with parents, and enough time on the child's visit and adequate advice and explanation to the parents when they did not need to prescribe antibiotics. In a study in Lebanon, consistent with our study, male physicians agreed with the request of parents for antibiotic prescription more than female ones (18).…”

Effect of Intervention Training on Pharmacists’ Knowledge and Attitude to Antibacterial Counselling

“…Despite all efforts, irrational usage of antibacterials continues to thrive. Patients need to be adequately counselled, [2,20] the effectiveness of which depends on the knowledge and attitude of pharmacists to antibacterial counselling.…”

“…It was a cross sectional survey among all the forty five pharmacists involved with dispensing and counselling of patients at the outpatients department of the health care institutions. The study comprises of (1) baseline survey (2) intervention and (3) post intervention survey. The limited number of available pharmacists compels the inclusion of all eligible pharmacists in the study.…”

“…The great success in the treatment of bacterial infections and related diseases is being seriously threatened by the insurgence of antibacterial resistance [1,2]. Antimicrobial resistance (AMR) is the loss of efficacy of antibacterial agent against originally susceptible bacteria [3].…”

“…Irrational (non-prudent) antibacterial use has been identified to be the major cause of antibacterial resistance worldwide [4,5]. It may occur at different stages of antibacterial therapy including: indication, selection, dosage, treatment duration, antibacterial use and compliance with course of therapy [2,4].…”