Abstract
BackgroundThere is an increasing trend on the practices of parental self-medication with antibiotics (PSMA) around world, accelerating the antibiotic abuse. This study aims to examine the nationality differences in the practices of PSMA and knowledge, attitudes and practices (KAP) toward antibiotic use, and understand the practices of PSMA among parents of various nationalities in China.MethodsA cross-sectional study based on a structured questionnaire survey was conducted in Xi’an, Shaanxi Province, China, from September 2018 to October 2018. A total of 299 respondents participated in. The practices of PSMA (a dichotomous variable) and KAP toward antibiotic use (a continuous variable) served as dependent variables. Participant’s nationality was regarded as the independent variable. Binary logistic regression and ordinary least square regression were employed to examine the association between parent’s nationality and the practices of PSMA, and KAP toward antibiotic use, respectively.Results121 (40.88%) Chinese, 100 (33.76%) other Asians and 75 (25.34%) Occidentals were included in final analysis, with a sample size of 296. Chinese were more likely to practice PSMA (OR = 7.070; 95% CI 1.315, 38.01), with worse knowledge (Coef. = − 0.549; 95% CI − 1.021, − 0.078), attitudes (Coef. = − 3.069; 95% CI − 4.182, − 1.956) and practices (Coef. = − 1.976; 95% CI − 3.162, − 0.790) toward antibiotic use, compared to their Occidental counterparts. The main reasons for the practices of PSMA were enough previous medication experience (80.49%) and same ailments with no need to see a doctor (39.02%), with common symptoms such as fever (60.98%) and cough (58.54%). Purchasing antibiotics at pharmacies (92.08%) and using leftover antibiotics (26.83%) were usual approaches.ConclusionsThe study highlights the gaps in the practices of PSMA and KAP toward antibiotic use among parents of different nationalities. The access to obtain antibiotics from pharmacies reflects the pharmacists’ unaware of laws on prescription of antibiotics, fierce competition in the pharmacy market, and the government’s lax supervision in China. It suggests the need to improve pharmacists’ training, enforce current legislations on pharmacy market regarding the sale of antibiotics, and provide practical and effective educational interventions for residents about antibiotic use.
Highlights
There is an increasing trend on the practices of parental self-medication with antibiotics (PSMA) around world, accelerating the antibiotic abuse
Our results demonstrated that: (1) Chinese were more likely to practice PSMA, and performed worse KAP toward antibiotic use, compared to their Occidental counterparts; (2) the practices of PSMA occurred for symptoms such as fever and cough, mainly because of previous medication experience and the same ailments with no need to see a doctor; (3) the common sources of antibiotic information included previous medication experience, and the recommendations from relatives, friends and pharmacy personnel; (4) antibiotics for self-medication were often obtained from pharmacies and leftover of previous medication
It’s worth noting that nationality was associated with the practices of PSMA in this study, showing that Chinese parents were more likely to self-medicate with antibiotics for children than Occidental parents, the same as the above findings conducted in separate countries [18, 20, 23, 48, 52, 53]
Summary
There is an increasing trend on the practices of parental self-medication with antibiotics (PSMA) around world, accelerating the antibiotic abuse. A main adverse effect of antibiotic use, is mainly driven by irrational and excessive use of antibiotic in both communities and clinical settings [1]. It is regarded as an important public health concern [2] and one of the biggest threats facing global health [3]. There is an increasing trend on practicing self-medication with antibiotics (SMA) in both developed and developing countries in recent years, which is one of the most dangerous and prevalent inappropriate antibiotic use behaviors [6]. Antibiotics for self-medication are usually obtained without a prescription, or by resubmitting old prescriptions to purchase medicines at retail pharmacies, or sharing medicines with relatives or friends, or using leftover medicines stored at home [6, 13, 14]
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