Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Pennsylvania.
J Pediatric Infect Dis Soc. 2018 Dec 3;7(4):303-309. doi: 10.1093/jpids/pix073.
Parental pressure is often cited as a reason for why pediatricians overuse antibiotics for children with acute respiratory tract infection (ARTI). We sought to capture parent perceptions of antibiotics at the time of their child's presentation with an ARTI.
We conducted semistructured interviews with parents of children who presented with ARTI symptoms to 1 of 4 diverse practices in a large hospital-affiliated network of pediatric primary care practices. Parents were interviewed before their child was seen by the pediatrician and asked about their perceptions of antibiotics.
Interviews were conducted with 109 parents. None of the parents said they planned to ask the pediatrician for antibiotics but instead expected to gain reassurance and a plan to minimize symptoms. Three perceptions about antibiotics were identified: parents have a sense of wariness when their child is prescribed antibiotics, they have an understanding that antibiotic overuse is a problem but that it is driven by the demands of other parents, and they have a preference for alternative treatment. The majority of the parents were not concerned about antibiotic resistance. In response to closed-ended questions designed to assess their level of concern with adverse effects, parents were most concerned with their child developing an upset stomach, having an allergic reaction, and experiencing diarrhea. The parents were not concerned with antibiotic treatment failure.
Parents in our study expressed a sense of caution about antibiotics and an awareness that they should be used judiciously. Our findings indicate that parents are aware of the downsides of antibiotics and might be willing to partner with healthcare providers to improve appropriate use.
儿科医生过度使用抗生素治疗急性呼吸道感染 (ARTI) 的儿童,其原因常被归咎于父母的压力。我们试图在儿童出现急性呼吸道感染症状时,了解父母对抗生素的看法。
我们对在大型医院附属儿科初级保健实践网络的 4 个不同实践中就诊的患有急性呼吸道感染症状的儿童的家长进行了半结构化访谈。在儿科医生就诊前,对家长进行了访谈,询问他们对抗生素的看法。
共对 109 名家长进行了访谈。没有一位家长表示他们计划向儿科医生索要抗生素,而是期望获得安慰和减轻症状的方案。确定了三种对抗生素的看法:当孩子开了抗生素处方时,父母会感到警惕;他们明白抗生素过度使用是一个问题,但这是由其他父母的需求驱动的;他们更喜欢替代治疗。大多数家长并不担心抗生素耐药性。在回答旨在评估他们对不良反应担忧程度的封闭式问题时,父母最担心的是孩子会出现胃部不适、过敏反应和腹泻。家长并不担心抗生素治疗失败。
我们研究中的父母对使用抗生素表示谨慎,并意识到应该谨慎使用。我们的研究结果表明,父母意识到抗生素的缺点,并且可能愿意与医疗保健提供者合作,以改善抗生素的合理使用。