Abstract
BackgroundUpper respiratory tract infections (URTI) are common. The etiologic factor is usually viral, but many physicians prescribe antibiotics. We aimed to evaluate parents' expectations of and knowledge about the role of antibiotics in childhood URTI.MethodsThe study was conducted in thirteen primary care pediatric clinics. Parents of children aged 3 months to 6 years who attended with URTI symptoms were included when it was the first attendance in the current illness. Questionnaire about the current illness, reasons for attending and expectations from the visit, knowledge about URTI was filled before the visit.ResultsIn 122 visits the average age was 2.8 ± 1.9 years. The main reasons for the visit were to avoid complications (81%) and to be examined (78%). Expected treatment was: cough suppressants (64%), anti-congestants (57%), paracetamol (56%), natural remedies (53%) and antibiotics (25%). In 28% the child had received antibiotics in past URTI. Only 37% thought that antibiotics would not help in URTI and 27% knew that URTI is a self-limited disease. 61% knew that URTI is a viral disease. Younger parental age and higher education were associated with lower expectations to receive antibiotics (p = 0.01, p < 0.005 respectively). While previous antibiotic treatment (p < 0.001), past perceived complications (p = 0.05) and the thought that antibiotics help in URTI (p < 0.001) were associated with a greater expectation for antibiotics.ConclusionsA quarter of the parents attending the physician with URTI are expecting to get antibiotics. Predictors were lower education, older parental age, receiving antibiotics in the past and the belief that antibiotics help in URTI.
Highlights
Upper respiratory tract infections (URTI) are common
A quarter of the parents attending the physician with URTI expected to get antibiotics
Predictors were lower education, older parental age, and receiving antibiotics in the past and the belief that antibiotics help in URTI
Summary
The etiologic factor is usually viral, but many physicians prescribe antibiotics. In most cases the etiologic factor is viral and there is no need for antibiotic treatment [2,3]. Many physicians continue to prescribe antibiotic treatment for URTI, knowing that antibiotics do not help viral infection and despite the development of resistant bacterial strains. The factors that influence physicians decision to prescribe antibiotics for URTI are: suspected bacterial disease, the fear that a viral infection will lead to a secondary bacterial infection and doctors' belief that the patient expects to receive antibiotics for his illness [4]. Mangione-Smith et al noted that physicians' perceptions of parental expectations for antibiotics was the only significant predictor of actual prescribing of antibiotics for conditions of presumed viral etiology [9]. When physicians thought the parent wanted an antimicrobial, they were significantly more likely to give a bacterial diagnosis
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