Validation of the parental knowledge and attitude towards antibiotic usage and resistance among children in Tetovo, the Republic of Macedonia

Main Article Content

Edita Alili-Idrizi
Merita Dauti
Ledjan Malaj

Keywords

Anti-Bacterial Agents, Drug Resistance, Bacterial, Health Knowledge, Attitudes, Practice, Parents, Macedonia (Republic)

Abstract

Objective: This study sought to explore the knowledge and attitudes of parents on the use of antibiotics among children that could serve as baseline data and provide further insight in planning and developing strategies for local health education purposes.

Methods: A cross-sectional survey involving 500 parents who attended community pharmacies in Tetovo, Republic of Macedonia, was conducted using a self-administered questionnaire from October 2013 to January 2014. The questionnaire included demographics, knowledge and attitude statements of parents towards antibiotics. The data collected were analyzed using SPSS program, version 19.0. Descriptive statistics was used to summarize the data. In all statistical analyses, a p-value of <0.05 was considered statistically significant.

Results: Nearly 40% of the parents demonstrated a moderate level of knowledge. The highest correct response in the knowledge part was the awareness of parents in using antibiotics to treat a bacterial infection (61.2%). However, most of the parents did not know that antibiotics cannot cure viral infections (59.6%).  About 48.2% of the parents were aware of the antibiotic resistance as s result of the overuse. Concerning attitudes, 60.8% reported keeping any leftover antibiotics, 77.0% agreed that taking antibiotics when having cold symptoms could help their children recover faster, while, 74.6% wrongly agreed with the statement of appropriate use of antibiotics for prophylaxis’ measure.

Conclusions: This study has documented the main areas that merit attention when parental knowledge on antibiotic use for their children is the concern, reflecting in some inappropriate attitudes as well. The findings highlight the need to devise effective interventions to decrease misconceptions regarding antibiotic use and to increase parents’ awareness for the risks of inappropriate use of antibiotics in children specifically and in the community at large.

Abstract 2977 | PDF Downloads 1177

References

1. McLellan NJ, Gray J. The rational use of antibiotics in bacterial infection. Curr Pediatr. 2001;11(6):438-444. doi:10.1054/cupe.2001.0234

2. Krivoy N, El-Ahal WA, Bar-Lavie Y, Haddad S. Antibiotic prescription and cost patterns in a general intensive care unit. Pharm Pract (Granada). 2007;5(2):67-73.

3. Ghai OP, Paul VK. Rational drug therapy in pediatric practice. Indian Pediatr. 1988;25(11):1095-1109.

4. Summers RS, Summers B. Drug prescribing in paediatrics. Ann Trop Paediatr. 1986;6(2):129-133.

5. Dowell SF, Marcy SM, Phillips WR, Gerber MA, Schwartz B. Principles of judicious use of antimicrobial agents for pediatric upper respiratory tract infections. Pediatrics. 1998;101:163-165.

6. Nyquist AC, Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA. 1998;279(11):875-877.

7. Nash DR, Harman J, Wald ER, Kelleher KJ. Antibiotic prescribing by primary care physicians for children with upper respiratory tract infections. Arch Pediatr Adolesc Med. 2002;156(11):1114-1119.

8. Belongia EA, Naimi TS, Gale CM, Besser RE. Antibiotic use and upper respiratory infections: a survey of knowledge, attitudes, and experience in Wisconsin and Minnesota. Prev Med. 2002;34(3):346-352. doi:10.1006/pmed.2001.0992

9. Huang SS, Rifas-Shiman SL, Kleinman K, Kotch J, Schiff N, Stille CJ, Steingard R, Finkelstein JA. Parental knowledge about antibiotic use: results of a cluster-randomized, multicommunity intervention. Pediatrics. 2007;119(4):698-706.

10. Bi P, Tong SL, Parton KA. Family self-medication and antibiotics abuse for children and juveniles in a Chinese city. Soc Sci Med. 2000 May;50(10):1445-1450. doi:10.1016/S0277-9536(99)00304-4

11. Larsson M, Kronvall G, Chuc NTK, Karlsson I, Lager F, Hanh HD, Tomson G, Falkenberg T. Antibiotic medication and bacterial resistance to antibiotics: a survey of children in a Vietnamese community. Trop Med Int Health. 2000;5(10):711-721. doi:10.1046/j.1365-3156.2000.00630.x

12. Okumura J, Wakai S, Umenai T. Drug utilisation and self-medication in rural communities in Vietnam. Soc Sci Med. 2002;54(12):1875-1886. doi:10.1016/S0277-9536(01)00155-1

13. Cars O, Nordberg P. Antibiotic resistance –The faceless threat. Int J Risk Saf Med. 2005;17:103-110.

14. Haung K, Hsieh Y, Hung C, Hsiao F. Off-lab antibiotic use in the pediatric population: a population-based study in Taiwan. J Food Drug Anal. 2012;20(3):597-602.

15. Grigoryan L, Burgerhof JG, Haaijer-Ruskamp FM, Degener JE, Deschepper R, Monnet DL Cunney R, Di Matteo A, Edelsein H, Valinteliene R, Alkerwi A, Scicluna E, Grzesiowski P, Bara AC, Tesar T, Cizman M, Campos J, Lundborg CS, Birkin J, SAR group. Is self-medication with antibiotics in Europe driven by prescribed use? J Antimicrob Chemother. 2007;59(1):152-156. doi:10.1093/jac/dkl457

16. Väänänen MH, Pietilä K, Airaksinen M. Self-medication with antibiotics-does it really happen in Europe? Health Policy. 2006;77(2):166-171.doi:10.1016/j.healthpol.2005.07.001

17. Awad A, Eltayeb I, Matowe L, Thalib L. Self-medication with antibiotics and antimalarials in the community of Khartoum state, Sudan. J Pharm Pharm Sci. 2005;8(2):326-331.

18. Chan G, Tang SF. Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia. Singapore Med J. 2006;47(4):266-270.

19. Mitsi G, Jelastopulu E, Basiaris H, Skoutelis A, Gogos C. Patterns of antibiotic use among adults and parents in the community: A questionnaire-based survey in a Greek urban population. Int J Antimicrob Agents. 2005;25(5):439-443.

20. Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MA. Self-medication with antibiotics in jordanian population. Int J Occup Med Environ Health. 2007;20(4):373-380. doi: 10.2478/v10001-007-0038-9

21. Sarahroodi S, Arzi A, Sawalha AF, Ashtarinezhad A. Antibiotics self-medication among southern iranian university students. Int J Pharmacol. 2010;6:48-52. doi: 10.3923/ijp.2010.48.52

22. Crossley J, Eiser C, Davies H. Children and their parents assessing the doctor–patient interaction: a rating system for doctors’ communication skills. Med Educ. 2005;39(8):820-828.

23. Vanden Eng J, Marcus R, Hadler JL Imhoff B, Vugia DJ, Cieslak PR, Zell E, Deneen V, McCombs KG, Zansky SM, Hawkins MA, Besser RE. Consumer attitudes and use of antibiotics. Emerg Infect Dis. 2003;9(9):1128-1135.

24. Bajčetić M, Jovanović I. Current aspects of rational antibiotic use in paediatrics. Paediatrics Today 2012;8(2):79-90 doi: 10.5457/p2005-114.43

25. Deschepper R, Grigoryan L, Lundborg CS, Hofstede G, Cohen J, Kelen GV, Deliens L, Haaijer-Ruskamp FM. Are cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe? BMC Health Serv Res. 2008;8:123. doi: 10.1186/1472-6963-8-123

26. Panagakou SG, Theodoridou MN, Papaevangelou V, Papastergiou P, Syrogiannopoulos GA, Goutziana GP, Hadjichristodoulou CS. Development and assessment of a questionnaire for a descriptive cross – sectional study concerning parents' knowledge, attitudes and practices in antibiotic use in Greece. BMC Infect Dis. 2009;9:52. doi: 10.1186/1471-2334-9-52

27. McNulty CA, Boyle P, Nichols T, Clappison P, Davey P. Don’t wear me out--the public’s knowledge of and attitude to antibiotic use. J Antimicrob Chemother. 2007;59(4):727-738.

28. Shehadeh M, Suaifan G, Darwish RM, Wazaify M, Zaru L, Alja'fari S. Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi Pharm J. 2012;20(2):125-133. doi: 10.1016/j.jsps.2011.11.005

29. Ling Oh A, Hassali MA, Al-Haddad MS, Syed Sulaiman SA, Shafie AA, Awaisu A. Public knowledge and attitudes towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia. J Infect Dev Ctries. 2011;5(5):338-347.

30. Alzoubi K, Al-Azzam S, Alhusban A, Mukattash T, Al-Zubaidy S, Alomari N, Khader Y. An audit on the knowledge, beliefs and attitudes about the uses and side-effects of antibiotics among outpatients attending 2 teaching hospitals in Jordan. East Mediterr Health J. 2013;19(5):478-484.

31. Lim KK, Teh CC. A Cross sectional study of public knowledge and attitude towards antibiotics in Putrajaya, Malaysia. South Med Rev. 2012;5(2):26-33.

32. Abobotain AH, Sheerah HA, Alotaibi FN, Joury AU, Mishiddi RM, Siddiqui AR, Saeed AB. Socoi-demographic determinants of antibiotic misuse in children. Saudi Med J. 2013;34(8):832-840.

33. Tenaiji A, Redha KA, Khatri F, Darmaki S, Hosani S, Neaimi MA, Khan A, Hashmey R. Knowledge Attitudes and Behavior Towards Antibiotic Use among Parents in Al-Ain City, United Arab Emirates. Int J Infect Dis. 2008;12:e434

34. Romman HA. Patterns of antibiotic use among children. Int J Med Med Sci. 2013;5(6):264-272. doi:10.5897/IJMMS12.050

35. Al-Dossari K. Parental knowledge, attitude and practice on antibiotic use for upper respiratory tract infections in children. Majmaah J Health Sci. 2013;1(1):39-51.

36. Bauchner H, Pelton SI, Klein JO. Parents, physicians, and antibiotic use. Pediatrics. 1999;103(2):395-401.

37. Cummings KC, Rosenberg J, Vugia DJ. Beliefs about appropriate antibacterial therapy, California. Emerg Infect Dis. 2005;11(7):1138-1141.