Parents continue to have misconceptions about antibiotic use, according to a study published in the July issue of Pediatrics.
Researchers surveyed 1,500 parents in Massachusetts in the spring of 2013 who had a child less than 6 years old and were managed by either Medicaid or a commercial healthcare plan. They assessed current sociodemographic predictors of knowledge and evaluated changes in predictors from a similar survey conducted in 2000.
Survey items included knowledge of common childhood infections and antibiotic indications, attitudes toward antibiotic use, healthcare use and demographics. Questions included the role of antibiotics for specific childhood infections and on the difference between viral and bacterial infections.
According to the study, parents were asked to indicate how often antibiotics were needed (always/almost always, sometimes, never or almost never, don’t know) for seven of the questions. Other questions asked whether colds were caused by viruses or bacteria, whether antibiotics were helpful in treating bacterial or viral infections, and, on a five-point Likert scale, whether a child with a cold would be sicker without antibiotics.
“We considered responses correct if they reflected recommendations of the Centers for Disease Control and Prevention, Infectious Disease Society of America, and American Academy of Pediatrics and were consistent with published studies,” researchers stated.
They also asked questions designed to identify parents who had strong expectations for receiving antibiotics and included questions to identify their awareness of antibiotic side effects and resistance.
Researchers explored to what extent parents trust specific channels of health information such as physicians’ offices, public health entities, pharmacies, child care or schools, advertisements and social media.
Results showed that among commercially insured parents, knowledge remained high that green nasal discharge did not require antibiotics. This improved from 23% in the 2000 survey to 49% in 2013. Among Medicaid-insured parents, the increase was smaller — 22% in 2000 compared with 32% in 2013.
Medicaid-insured parents in 2013 (n = 345) were younger, were less likely to be white, and had less education than those commercially insured (n = 353), the study stated.
Fewer Medicaid-insured parents answered questions correctly except for one related to bronchitis, for which there was no difference (15% Medicaid vs. 16% commercial). Among Medicaid-insured parents, the percentage correctly answering otitis media and strep throat questions actually decreased in 2013, the researchers stated.
“We found very low levels of understanding that antibiotics are rarely needed for bronchitis, with marginal improvements over time in both groups,” they said.
Parents were more likely to request unnecessary antibiotics in 2013 compared to 2000. Researchers concluded that misconceptions about antibiotic use persist and continue to be more prevalent among parents of Medicaid-insured children. Efforts for reaching socioeconomically disadvantaged populations remain warranted to decrease the number of parents who drive physicians to prescribe antibiotics for their children.
“New strategies to change expectations about antibiotic use must be a continued focus of public health initiatives,” the researchers stated.
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