Abstract
Inappropriate use of antibiotics for upper respiratory tract infections (URTIs) in Chinese children is rampant. Parents' decision-making processes with respect to treatment choices and antibiotic use for paediatric URTIs were investigated to identify key constructs for effective interventions that target the public. Data were collected between June 2017 and April 2018 from a random cluster sample of 3188 parents of children aged 0-13 years across three Chinese provinces, representing different stages of economic development. Risk factors of parents' treatment choices and antibiotic use for paediatric URTIs were assessed using binary and multinomial logistic regressions, adjusting for socio-demographic characteristics. A total of 1465 (46.0%) children of the 3188 parents who self-diagnosed their children with a URTI were given antibiotics, with or without prescription. Among these children, 40.5% were self-medicated with antibiotics by their parents and 56.1% obtained further antibiotic prescriptions at healthcare facilities. About 70% of children (n=2197) with URTI symptoms sought care; of these, 54.8% obtained antibiotic prescriptions and 7.7% asked for antibiotic prescriptions, with 79.4% successfully obtaining them. Those perceiving antibiotics as effective for treating the common cold and fever (adjusted odds ratio [aOR]=1.82[95% confidence interval, 1.51-2.19] and 1.77[1.47-2.13], respectively), who had access to non-prescription antibiotics (aOR=5.08[4.03-6.39]), and with greater perceived severity of infection (aOR=2.01[1.58-2.56]), were more likely to use antibiotics. Multifaceted, context-appropriate interventions are vital to untangle the perpetual problem of self-medication, over-prescription and ill-informed demands for antibiotics. The findings in this study emphasise the need to prioritise interventions that enhance clinical training, neutralise the pressure from patients for antibiotics, educate on appropriate home care, discourage antibiotic self-medication and improve antibiotic dispensing.
Highlights
Inappropriate use of antibiotics for upper respiratory tract infections (URTIs) in Chinese children is rampant
A total of 1465 (46.0%) children of the 3188 parents who self-diagnosed their children with a URTI were given antibiotics, with or without prescription
About 70% of children (n=2197) with URTI symptoms sought care; of these, 54.8% obtained antibiotic prescriptions and 7.7% asked for antibiotic prescriptions, with 79.4% successfully obtaining them
Summary
Data were collected between June 2017 and April 2018 from a random cluster sample of 3188 parents of children aged 0-13 years across three Chinese provinces, representing different stages of economic development. Data were assessed from a survey of parents with children aged 0-13 years between June 2017 and April 2018. The questionnaire comprised four sections: 1) parental socio-demographic information; 2) healthcare- and antibiotic-related knowledge and perceptions; 3) last episode of URTI symptoms experienced by the child within the past month, and 4) treatment and parental care-seeking process and behaviours for the child’s illness (i.e., the chemical or brand names of antibiotics obtained from clinics and retail pharmacies). To minimise the burden for the parents and ensure high quality of the response data, the survey was designed to take no more than 10 minutes to complete and an internet protocol (IP) address control was put in place to detect random responses or duplications. 33.5% (n=3188) reported that their children had experienced symptoms of a URTI within a month prior to the survey, including cold (cough, runny/stuffy nose), fever, sore throat, headache, and flu, either alone or in combination [1]
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