Risk Factors of Antibiotic Misuse for Upper Respiratory Tract Infections in Children: Results from a Cross-Sectional Knowledge-Attitude-Practice Study in Greece

Abstract

Background. Upper 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 identify possible risk factors associated with antibiotic misuse in Greece, a country with high levels of antibiotic use and antibiotic resistance. Methods. A knowledge-attitude-practice (KAP) 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. Results. The sample of the study contained 5312 parents from all geographic areas of Greece. The risk factors of being a father, having low education, having immigrant status, being a single parent, having low income, having <2 or >3 children, living in the islands, and being without experience in recurrent URTIs were significantly associated to inadequate knowledge, inappropriate attitudes, and wrong practices. Conclusions. This study has identified the main groups of parents that should be targeted in future intervention programs.

Knowledge and attitudes towards the use of antibiotics in the paediatric age group: a multicenter survey in Italy

“…[10][11][12][13][14][15][16][17][18][19] This could lead to an inappropriate administration of antibiotics to children, given that from 10% to 60% of parents declare to administer antibiotics without medical prescription. [11][12][13]15,19 Moreover, several studies demonstrated that attitudes of parents could influence the decision of the paediatrician about the prescription of an antibiotic, making the lack of knowledge of the parents about this issue even more dangerous. 14,20 To date no studies have evaluated knowledge and attitudes on antibiotics among parents of children aged between 0-14 years in Italy.…”

Shared decision making in primary care: barriers and facilitators of shared decision making in the context of decreasing the use of unnecessary antibiotics for preschool children ages 3-5 with upper respiratory tract infections

“…Strategies to move forward without prescribing antibiotics were not provided in any of the literature reviewed. Although parents may request an antibiotic at the beginning of the consultation, a consensus evident in the literature was that improving the communication between PCPs and patients/parents will reduce requests for antibiotics for viral URIs at the end of a consultation, after shared decision making has occurred (Brookes-Howell et al, 2014;Butler et al, 2012;Giguere et al, 2012;Hoye et al, 2010;Legare et al, 2013;Legare et al, 2012;Mangione-Smith et al, 2015;Mustafa et al, 2014;Panagakou et al, 2012;van der Velden et al, 2013;& Yin et al, 2012). Parents who received non-antibiotic therapy suggestions as well as a follow up plan…”

“…Parents may not be aware of the potential risks and limited benefits of antibiotics for URIs (Panagakou et al, 2012;Rouusounides et al, 2011;Yin et al, 2012). Continued education of parents surrounding the lack of efficacy of antibiotics for the majority of URIs is required to reduce unnecessary antibiotic use (Atliner et al, 2013;Panagakou et al, 2012).…”

“…Continued education of parents surrounding the lack of efficacy of antibiotics for the majority of URIs is required to reduce unnecessary antibiotic use (Atliner et al, 2013;Panagakou et al, 2012). In order to provide information about URIs, PCPs must first explore and assess the parent's pre-existing knowledge, and then allow parents to ask questions once URI education has been provided.…”

“…The main risk factor identified that impacted parental knowledge of URIs was low socioeconomic status, with associated factors identified as language barriers, immigrant status, low health literacy, being a single parent, and care provided by single fathers (Panagakou et al, 2012;Yin et al, 2012 In order to increase parental knowledge and encourage open dialogue between PCPs and parents, educational handouts can be utilized (Butler et al, 2012;Yin et al, 2012).…”