Abstract
BackgroundSelf-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China.MethodsA cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed.ResultsOne-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]).ConclusionsTailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.
Highlights
Antimicrobial resistance (AMR) is recognized as one of the biggest threats facing global health; inappropriate use of antibiotics, including antibiotic misuse and overuse in both community and clinical settings, is a major contributor to AMR [1, 2]
Parents who have self-medicated their children before a consultation were more likely to ask for antibiotics, including IV antibiotics, during the consultation, and their requests were more likely to be fulfilled by doctors
Our study found that Self-medication with antibiotics (SMA) parents were more likely to ask for antibiotics and their requests were more likely to be fulfilled by the doctors, which explains how SMA triggered antibiotic prescriptions in clinical settings
Summary
Antimicrobial resistance (AMR) is recognized as one of the biggest threats facing global health; inappropriate use of antibiotics, including antibiotic misuse and overuse in both community and clinical settings, is a major contributor to AMR [1, 2]. A qualitative study conducted across nine European cities revealed that, Xu et al Antimicrobial Resistance and Infection Control (2020) 9:150 when noticing their patients had started using antibiotics before the consultation, doctors would advise patients to complete their course of antibiotics, even if they thought antibiotics were unnecessary [8] Another quantitative study conducted in a city in Poland indicated that doctors were more likely to prescribe antibiotics (aOR = 4.11) when patients had self-medicated with antibiotics before the consultation [9]. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China
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