Antibiotics: Do we use them too much?

A summary of a recent journal article in Pediatrics (Prevalence of Parental Misconceptions About Antibiotic Use by Louise Elaine Vaz, et al. Pediatrics, Volume 136, number 2, August 2015)

Known: Efforts have been made to reduce antibiotic misuse and overprescribing in order to slow down antibiotic resistance. Many parents have differences in knowledge of appropriate antibiotic use. There have been differences reported in both knowledge and attitudes between parents of Medicaid and commercially insured children. These differences may lead parents to mistakenly believe antibiotics are needed, and some providers in turn may respond to their perception of parental expectations by prescribing unnecessary antibiotics.

Unknown: What are trends in current understanding and knowledge, and has understanding improved?

Study: 1500 Massachusetts parents with a child <6 years of age were randomly selected and were surveyed by mail in 2013. The survey asked questions about knowledge of common childhood infections, attitudes toward antibiotic use, the role of antibiotics for specific childhood infections, the differences between viral and bacterial infections, awareness of antibiotic side effects and resistance, and the extend of trust families placed in specific channels of health information.

Results: The average number of reported antibiotic courses was <1. Few parents reported giving their child an antibiotic without talking to a physician first. Very few reported requesting any specific antibiotic. Medicaid insurance parents generally expressed more concern for side effects from antibiotic use. Parents expressed high levels of trust in their physician. However, there were differences noted. Medicaid insured parents in 2013 were younger, were less likely to be white and had less education than those commercially insured. Fewer Medicaid parents answered questions correctly about antibiotic use and Medicaid parents were more likely to request unnecessary antibiotics than wait and see. Interestingly, race was an inconsistent predictor of knowledge.

Conclusions: Despite efforts to decrease unnecessary antibiotic use, misconceptions about antibiotic use persist and are more prevalent among parents of Medicaid children. Parents had high rates of knowing when antibiotics were needed but were not as good at identifying when antibiotics were not needed. These concepts are complex and include identifying differences between viruses and bacteria and the fact that viruses are never treated (with exception of influenza) and that bacterial infections often are. Child care, employment or transportation may be behind the additional expectations. We must continue efforts to decrease unnecessary antibiotic prescribing by increasing patient knowledge. Parents also relay on different sources for their medical information including nurses, pharmacies, schools and we should try to continue to improve communication through less formal sites.

If you have questions about your child’s medication, don’t hesitate to call your child’s pediatrician at 239-573-2001.

About author MacKoul Pediatrics

MacKoul Pediatrics is an amazing local pediatrics office in Cape Coral, FL where caring, compassionate doctors and nurses work with you to keep your children as healthy as possible. MacKoul cares for children from birth to college age, from Cape Coral, Fort Myers, Naples, and beyond.