Antibiotic Resistance In Children: Parents’ Knowledge and Practices

Background: Antibiotic resistance related to inadequate and excessive use of antibiotics is one of the biggest public health challenges of our time, including in paediatrics.

Objective: Evaluate parents’ knowledge about antibiotics resistance and practices regarding antibiotic use.

Methods: Cross-sectional study: authors’ designed questionnaire hosted on GoogleForms between August-October/2020. The questionnaire covered knowledge of antibiotics (18 statements: one point for each correct answer; total results divided into three categories: poor (0-8), moderate (9-14) and good (15-18) knowledge), and antibiotic practices (4 statements). An infographic was available at the end of the questionnaire.

Results: Among 817 questionnaires, 96.3% female respondents, 60.7% had more than one child and 82.7% a university degree or above. 50.4% and 39,5% showed a moderate and good knowledge of antibiotics, respectively. 85.8% knew that antibiotics were used to treat bacteria and not virus. More than 95% stated that antibiotics were not indicated for treating all diseases with fever, common cold or flu. Simultaneously, approximately half erroneously agreed that antibiotics were indicated for all acute tonsillitis, otitis media and bronchiolitis. More than 90% recognized as an inappropriate use of antibiotics: not being recommended, incorrect dosing and shorter duration than recommended, with 56,7% not considering longer duration. 72,7% recognized antibiotic misuse as a cause of antibiotic resistance. Better knowledge was positively associated with higher education(p<0.05). Almost half never heard about antibiotic resistance in paediatric age. 83.6% and 52.8% used their paediatrician and family doctor, respectively, as their source of information. Less than 2% have used a non-prescribed antibiotic and 12.5% resorted for a second medical opinion after an antibiotic not being prescribed.

Conclusion: This study, the first in a Portuguese population, revealed a good parents’ knowledge of antibiotics, besides obvious gaps. Despite 12.5% resorting for second opinion, a minor percentage used non prescribed antibiotics and the majority seek their physicians as main source of information.