Annotated abstracts*1

Abstract

3Taylor, JA, Kwan-Gett, TSC, & Mcmahon, EM (2003). Effectiveness of an educational intervention in modifying parental attitudes about antibiotic usage in children. Pediatrics, 111, e548-e554. An increase in antibiotic-resistant bacteria is of great concern for all healthcare providers, and for pediatric providers in particular. One factor contributing to this problem is the over-prescribing of antibiotics. A number of approaches to decreasing this overuse have been implemented, including development of practice guidelines for common pediatric problems and education programs for pediatric health care providers. However, a major impetus for providers to prescribe antibiotics is often parental expectations that an antibiotic will be prescribed. Interventions need to be directed to educating parents on the appropriate use of antibiotics. The purpose of this study was to assess whether a pamphlet, “Your Child and Antibiotics,” and an accompanying short video would improve parents' attitudes about the judicious use of antibiotics. Parents of children under 24 months of age seen for care at eight pediatric practices were invited to participate in this study. At enrollment, parents completed a questionnaire that included items about appropriate antibiotic use of antibiotics. Then parents were randomized to either an experimental group that received educational materials about antibiotic use or to a control group that was provided information about injury prevention. Six weeks following the educational session, families again completed the questionnaire about appropriate antibiotic use. From the 500 parents enrolled in the study, 72% returned the follow-up questionnaire. The results comparing the before and after responses on the two questionnaires showed that the parents in the group that received the educational program about antibiotic use were less likely to believe that antibiotics were necessary for specific conditions than the control group, although there were no differences between the two groups on general statements about antibiotic use. This study demonstrates that a simple education program can change parent attitudes about the appropriate use of antibiotics in children. Interestingly, simple education programs are often not successful in changing behaviors. The authors suggested that they might have been able to demonstrate a change in the experimental groups attitudes because their population was highly educated, they had a larger sample than other studies, and their questionnaire may have been more sensitive. PNPs in primary care practices often provide similar information to parents in their practices. The pamphlet, “Your Child and Antibiotics,” is available through the American Academy of Pediatrics. In addition, PNPs have a great deal of expertise in developing and presenting educational programs on a range of topics. PNPs should test the efficacy of similar educational interventions in their practices, clarifying what programs are most effective for which client groups, and sharing the results with their colleagues in their professional journal.