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

Abstract

Background Inappropriate use of antibiotics can promote bacterial resistance, which is a growing public health concern. As children are amongst the highest recipients of antibiotics, understanding the drivers of parental decisions towards their children’s antibiotic use is imperative for the development of strategies to assist parents in making more informed decisions. This is particularly relevant to the decisions of parents living in resource-limited settings. This study explored the perspectives and practices of parents living in a rural setting about the use of antibiotics in their children. Methods Three focus group interviews were conducted with 10 parents of children under 12yrs, living in rural and remote areas of the Northern Territory, Australia. A focus group guide was developed to facilitate discussions, which was informed by the Theory of Planned Behaviour. Transcripts were analysed abductively using thematic analysis. Findings Four themes emerged explaining factors that contributed to parent decisions about their children’s antibiotic use: 1) Parental knowledge, attitudes and decision making; 2) Perceptions of antimicrobial resistance; 3) Healthcare challenges; 4) Behaviours with antibiotics. While parents demonstrated accurate knowledge of the indications for antibiotic use, their decisions about the need for antibiotics were often driven by fear of serious illness. This fear was exacerbated by resource limitations associated with living in a resource-limited setting. Additional drivers of parental decision making included what parents have read or heard from both medical and non-medical networks, underscoring the importance of Social Norms in predicting behavioural intentions. Conclusion Mothers living in remote areas experiencing reduced access to health services may make decisions about antibiotic use out of fear and based on the advice of their personal network when they perceive their child is vulnerable to a health threat. Findings from this study provide guidance for future research in the prediction of antibiotic use behaviours and for context-specific interventions.

Changes in parental anxiety and intention to demand antibiotics: A longitudinal study among parents during the COVID‐19 pandemic

“…The bridging of these discordant views between physicians and parents can be performed by nurses through their communication skills and connections with both physicians and patients. This may be particularly relevant in rural and remote areas with limited access to services (Marsh et al, 2023).…”

Parental knowledge, attitude, and practice on self-medication of antibiotics for children in Bandung, Indonesia: A questionnaire-based survey and module-based learning intervention

“…Furthermore, in Southeast Asia, including Indonesia, a signi cant concern arises, with 83% of children affected by E. coli strains that are resistant to commonly prescribed rst-line antibiotics [6]. We cannot understate the essential role of parents as primary decision-makers in the acquisition and administration of medications in children, as they signi cantly in uence the proper use of antibiotics in this population [7]. As stated by the World Health Organization (WHO), there is a signi cant knowledge gap regarding antibiotics and their appropriate use.…”

“…Various factors, including knowledge and beliefs, the severity of children's illnesses, the availability of antibiotics, the children's age, and the speci c circumstances at hand, in uence parents' behavior regarding the use of antibiotics [7]. Studies investigating parental viewpoints on antibiotic use span a wide spectrum, from misconceptions to well-informed segments of the population.…”