Yannan Xu1, Jingjing Lu2, Chenhui Sun3, Xiaomin Wang4, Yanhong Jessika Hu5, Xudong Zhou6. 1. The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. seanxuzju@zju.edu.cn. 2. The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. jingjinglu@zju.edu.cn. 3. The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. sunchenhui@zju.edu.cn. 4. The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. xiaominwang2018@zju.edu.cn. 5. Murdoch Children's Research Institute, University of Melbourne. Royal Children's Hospital, Parkville, Australia. huhubest@gmail.com. 6. The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. zhouxudong@zju.edu.cn.
Abstract
INTRODUCTION: Antimicrobial resistance is a global health crisis and primarily caused by antibiotic misuse. Antibiotic misuse among children is particularly concerning, and its prevalence may vary from region to region in China with different development levels. METHODOLOGY: Zhejiang and Shaanxi were selected to represent developed and less developed provinces in China, respectively. Data of 2924 parents in Zhejiang and 3355 parents in Shaanxi whose children were 0-13 years old were collected through multi-stage stratified cluster random sampling and a self-administrated questionnaire. Chi-square tests and logistic regression models were used for statistical analysis. RESULTS: Compared to parents in Zhejiang, those in Shaanxi were more likely to keep antibiotics for children at home, to engage in self-medication with antibiotics for children, and to make their children take antibiotics prophylactically. While there were no significant provincial differences between parents' requests for antibiotics during pediatric consultations, parents in Shaanxi province were more likely to receive prescribed antibiotics. CONCLUSIONS: Children in less developed provinces face higher risks of antibiotic misuse at home as well as when attending medical practitioners. Comprehensive educational interventions are required to improve antibiotic use for children all over China but particularly in less developed provinces such as Shaanxi. Furthermore, non-prescription sales and over-prescribing of antibiotics should be reduced by targeted strategies. Copyright (c) 2020 Yannan Xu, Jingjing Lu, Chenhui Sun, Xiaomin Wang, Yanhong Jessika Hu, Xudong Zhou.
INTRODUCTION: Antimicrobial resistance is a global health crisis and primarily caused by antibiotic misuse. Antibiotic misuse among children is particularly concerning, and its prevalence may vary from region to region in China with different development levels. METHODOLOGY: Zhejiang and Shaanxi were selected to represent developed and less developed provinces in China, respectively. Data of 2924 parents in Zhejiang and 3355 parents in Shaanxi whose children were 0-13 years old were collected through multi-stage stratified cluster random sampling and a self-administrated questionnaire. Chi-square tests and logistic regression models were used for statistical analysis. RESULTS: Compared to parents in Zhejiang, those in Shaanxi were more likely to keep antibiotics for children at home, to engage in self-medication with antibiotics for children, and to make their children take antibiotics prophylactically. While there were no significant provincial differences between parents' requests for antibiotics during pediatric consultations, parents in Shaanxi province were more likely to receive prescribed antibiotics. CONCLUSIONS:Children in less developed provinces face higher risks of antibiotic misuse at home as well as when attending medical practitioners. Comprehensive educational interventions are required to improve antibiotic use for children all over China but particularly in less developed provinces such as Shaanxi. Furthermore, non-prescription sales and over-prescribing of antibiotics should be reduced by targeted strategies. Copyright (c) 2020 Yannan Xu, Jingjing Lu, Chenhui Sun, Xiaomin Wang, Yanhong Jessika Hu, Xudong Zhou.