Julia E Szymczak1, Sarah B Klieger2, Matthew Miller2, Alexander G Fiks2,3, Jeffrey S Gerber1,2,4. 1. Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. 2. Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Pennsylvania. 3. Department of General Pediatrics, Children's Hospital of Philadelphia, Pennsylvania. 4. Division of Infectious Diseases, Children's Hospital of Philadelphia, Pennsylvania.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Jeffrey S Gerber; Rachael K Ross; Matthew Bryan; A Russell Localio; Julia E Szymczak; Richard Wasserman; Darlene Barkman; Folasade Odeniyi; Kathryn Conaboy; Louis Bell; Theoklis E Zaoutis; Alexander G Fiks Journal: JAMA Date: 2017-12-19 Impact factor: 56.272
Authors: Marci Drees; Kimberly Fischer; Loretta Consiglio-Ward; Janelle Caruano; Shannon Chan; William Chasanov; Jami Jones; Alexander Kashmanian; Jillian D Laude; Nicole Harrington; Bcps Aq-Id; Elizabeth A Richardson; Arezoo Zomorrodi; Robert Dressler Journal: Dela J Public Health Date: 2019-05-28
Authors: Sima L Sharara; Alicia I Arbaje; Sara E Cosgrove; Ayse P Gurses; Kathryn Dzintars; Nicholas Ladikos; Sarojini Sonjia Qasba; Sara C Keller Journal: J Patient Saf Date: 2022-04-01 Impact factor: 2.844
Authors: Charlotte Z Woods-Hill; Anping Xie; John Lin; Heather A Wolfe; Alex S Plattner; Sara Malone; Kathleen Chiotos; Julia E Szymczak Journal: JAC Antimicrob Resist Date: 2022-01-22