McCall Becky, Hayward Andrew, Wilson Michael, Forbes Gill, Shallcross Laura
Institute of Health Informatics,, University College London,, London, UK.
Institute of Epidemiology and Health Care,, University College London,, London, UK.
F1000Res. 2025 Jun 10;11:1487. doi: 10.12688/f1000research.128550.3. eCollection 2022.
Most antibiotic prescribing occurs in primary care, largely in children under 5 years old, and often inappropriately. This study investigated knowledge, attitudes and behaviours (KABs) towards common childhood infections, antibiotic use and antimicrobial resistance (AMR), among parents of children under 5 years old. The concept of individual sacrifice (forgoing antibiotics-a selective pressure for AMR) to mitigate future societal risk of AMR and how the COVID-19 pandemic shaped views were explored.
This qualitative study included three, one-hour, virtual focus groups with mothers from parenting networks across inner-city London and semi-rural England, held mid-pandemic (2020). All had ≥1 child <5 years old. The Framework Method of analysis was used. Parents' KABs towards antibiotic use/AMR formed the primary outcome, with emphases on their sense of personal agency towards mitigating the threat of AMR for society, plus how the pandemic influenced views on infection prevention and care.
Fourteen mothers (groups of six, four, four) participated, with mixed ethnicities, education and employment status. Parent perceptions of their individual child's immediate need for antibiotics outweighed concerns for any possible future threat of AMR to society. Four key themes were identified: uncertainty around symptoms; impact of socio-cultural background on KAB; poor understanding of how antibiotics/AMR work; and opportunities within the doctor-patient dialogue to shape mindset around AMR. The pandemic influenced views across themes.
Parents prioritising their child's perceived, immediate, individual 'need' for antibiotics over any future impact of AMR on society highlights a continuing need to engage parents in how to mitigate AMR through appropriate antibiotic use, reducing threat to both their child and others. Framing point-of-care dialogue around antibiotic use/AMR in the present (versus future), drawing on pandemic insights and tailoring according to nuanced socio-cultural influences, may encourage a greater sense of personal agency towards taking action to mitigate antibiotic resistance.
大多数抗生素处方是在初级医疗保健中开出的，主要针对5岁以下儿童，而且常常是不恰当的。本研究调查了5岁以下儿童的父母对常见儿童感染、抗生素使用和抗菌药物耐药性（AMR）的知识、态度和行为（KABs）。探讨了个人牺牲（放弃使用抗生素——AMR的一种选择压力）以减轻未来AMR对社会的风险这一概念，以及新冠疫情如何塑造了人们的观点。
这项定性研究包括在疫情中期（2020年）与来自伦敦市中心和英格兰半农村地区育儿网络的母亲们进行的三场为期一小时的虚拟焦点小组讨论。所有参与者都有≥1名5岁以下儿童。采用框架分析法。父母对抗生素使用/AMR的KABs构成主要结果，重点是他们对减轻AMR对社会威胁的个人能动感，以及疫情如何影响对感染预防和护理的看法。
14位母亲（分别为6人、4人、4人的小组）参与，她们的种族、教育程度和就业状况各不相同。父母对自己孩子当下对抗生素的直接需求的认知超过了对AMR未来可能对社会造成的任何威胁的担忧。确定了四个关键主题：症状的不确定性；社会文化背景对KAB的影响；对抗生素/AMR作用方式的理解不足；以及医患对话中围绕AMR塑造思维模式的机会。疫情影响了各个主题的观点。
父母将孩子当下对抗生素的感知到的、直接的个人“需求”置于AMR对社会的任何未来影响之上，这凸显了持续需要让父母参与到如何通过适当使用抗生素来减轻AMR的问题中，从而减少对自己孩子和他人的威胁。利用疫情期间的见解，围绕当下（而非未来）抗生素使用/AMR进行即时护理对话，并根据细微的社会文化影响进行调整，可能会鼓励人们更有个人能动感地采取行动减轻抗生素耐药性。
