The knowledge and expectations of parents about the role of antibiotic treatment in upper respiratory tract infection – a survey among parents attending the primary physician with their sick child
Shlomo Vinker*, Adi Ron and Eliezer Kitai
Address: Department of Family Medicine, Tel Aviv Sackler school of Medicine, TelAviv, Israel Email: Shlomo Vinker* - firstname.lastname@example.org; Adi Ron - email@example.com; Eliezer Kitai - firstname.lastname@example.org * Corresponding author
Published: 30 December 2003 BMC Family Practice 2003, 4:20 This article is available from: http://www.biomedcentral.com/1471-2296/4/20
Received: 25 June 2003 Accepted: 30 December 2003
© 2003 Shlomo et al; licensee BioMed CentralLtd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
Upper respiratory tract infectionantibioticschildrenparentsknowledgeattitude
Background: Upper 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. Methods: The 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 aboutthe current illness, reasons for attending and expectations from the visit, knowledge about URTI was filled before the visit. Results: In 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%) andantibiotics (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. Conclusions: A 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 inURTI.
Patients with Upper Respiratory Tract Infection (URTI) constitute a major part of the primary care physician's workload during the winter months . 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 anddespite the development of resistant bacterial strains.
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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' beliefthat the patient expects to receive antibiotics for his illness . URTI is the most common infectious disease in children, with five to eight episodes each year 1. Previous studies in the USA and UK had shown that more than 30% of parents expected their child with URTI to receive antibiotic treatment at the first visit to the pediatrician [5,6]. Mangione-Smith et al noted that fifty percent of...