Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia
Introduction: A study was carried out in a primary healthcare clinic in the Hulu Langat district of Malaysia to assess the parental knowledge, attitudes and antibiotic use for common childhood acute upper respiratory tract infection (UrtI).
Methods: A cross-sectional study involving 421 parents, who were surveyed by using an interviewer-administered questionnaire, from April to June 2001.
Results: Approximately 59 percent of parents from this study believed that weather was the main cause of acute UrtI of their children, 13 percent thought it was due to food, and only about 27 percent said it was caused by germs. Nearly 68 percent, 69 percent and 76 percent of them believed that antibiotics was helpful in treating the common cold, cough and fever, respectively. 29 percent of parents who thought that their child with acute UrtI needed antibiotics were not prescribed with any. On the other hand, 17 percent believed that antibiotics were unnecessary when prescribed. 28 percent of parents had requested for antibiotics, and 93 percent received what they requested for their child with acute UrtI. About 31 percent of parents who did not request any antibiotics claimed that private general practitioners habitually prescribed antibiotics. the antibiotic compliance was poor with only 74 percent completing the entire course, with 85 percent of them stopping once they improved symptomatically. 15 percent of parents gave “leftover” antibiotics, 24 percent gave “shared” antibiotics, and 5.5 percent bought antibiotics for their child with acute UrtI without consulting a doctor.
Conclusion: this study shows that parents often have inadequate knowledge and misconceptions on antibiotic use for Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysiachan G c, tang s FPeringgit Community Polyclinic Jalan Pantai PeringgitMelaka 75450Malaysia Chan G C, MD, MMedFamily Medicine SpecialistDepartment of PaediatricsUniversiti Kebangsaan MalaysiaJalan Yaacob Latiff Kuala Lumpur 56000 MalaysiaTang S F, MD, MMed, MRCPAssociate ProfessorCorrespondence to:Dr Giin-Cherng Chan Klinik Cheng20 Jalan CB-1Taman Cheng BaruMelaka 75250, Malaysia Tel: (60) 6 312 1333 Fax: (60) 6 312 1333 Email: firstname.lastname@example.org O r i g i n a l A r t i c l eacute UrtI in children. Improved parental education may reduce unnecessary antibiotic prescription and antimicrobial resistance in the community.
World Health Organisation (WHO). The management of acute respiratory infections in children: Practical guidelines for outpatient care. Geneva: WHO, 1995.
Public Health Institute, Ministry of Health. National health and morbidity survey II 1996 Malaysia. Malaysia: Ministry of Health, 1997.
Gwaltney JM Jr. The common cold. In: Mandell GL, Bennet JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 4th ed. New York: Churchill Livingstone, 1995: 561-6.
Nyquist AC, Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA 1998; 279:875-7. Erratum in: JAMA 1998; 279:1702.
Arroll B, Kenealy T. Antibiotics in the common cold, a meta-analysis: The Cochrane database of systematic reviews. Issue 2, 2000.
Mainous AG III, Hueston WJ, Clark JR. Antibiotics and upper respiratory infection: do some folks think there is a cure for the common cold? J Fam Pract 1996; 42:357-61.
Palmer DA, Bauchne, H. Parents’ and physicians’ view on antibiotics. Pediatrics 1997; 99:e6.
Collett CA, Pappas DE, Evans BA. Parental knowledge about common respiratory infections and antibiotic therapy in children. Southern Med J 1999; 92:971-6.
Bauchner H, Pelton SI, Klein JO. Parents, physicians and antibiotic use. Pediatrics 1999; 103:395-401.
Erling V, Jalil F, Hanson LA, Zaman S. The impact of climate on the prevalence of respiratory tract infections in early childhood in Lahore, Pakistan. J Public Health Med 1999; 21:331-9.
Chang B. Some dietary beliefs in Chinese folk culture. J Am Diet Assoc 1974; 65:436-8.
Chen PCY. Traditional and modern medicine in Malaysia. Am J Chin Med 1979; 7:259-75.
Kunin CM, Lipton HL, Tupasi T, Sacks T. Social, behavioral and practical factors affecting antibiotic use worldwide: report of Task Force 4. Rev Infect 1987; 9:S270-85.
Barden LS, Dowell SF, Schwartz B, Lackey C. Current attitudes regarding antibiotic use: results from physicians’ and parents’ focus group discussions. Clin Pediatr 1998; 37:665-71.
Smith RM, McGlynn EA, Elliott MN, Krogstad P, Brook RH. The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior. Pediatrics 1999; 103:711-8.
Watson RL, Dowell SF, Jayaraman M, et al. Antimicrobial use for pediatric upper respiratory infections: reported practice, actual practice, and parent beliefs. Pediatrics 1999; 104:1251-7.
Hong JS, Philbrick JT, Schorling JB. Treatment of upper respiratory infections: do patients really want antibiotics? Am J Med 1999; 107:511-5.
Mayefsky JH, Shinaway YE, Kelleher P. Families who seek care for the common cold in a pediatric emergency department. J Pediatr 1991; 119:933-4.
Hamm RM, Hicks RJ, Bemben DA. Antibiotics and respiratory infections: are patients more satisfied when expectations are met? J Fam Pract 1996; 43:56-62.
Dowell SF, Marcy SM, Phillips WR, Gerber MA, Schwartz B. Otitis media - principles of judicious use of antimicrobial agents. Pediatrics 1998; 101 Suppl:S165-71.
Schwartz B, Marcy SM, Phillips WR, Gerber MA, Dowell SF. Pharyngitis-principles of judicious use of antimicrobial agents. Pediatrics 1998; 101 Suppl:S171-4.
O’Brien KL, Dowell SF, Schwartz B, et al. Acute sinusitis-principles of judicious use of antimicrobial agents. Pediatrics 1998; 101 Suppl:S174-7.
O’Brien KL, Dowell SF, Schwartz B, et al. Cough illness/bronchitisprinciples of judicious use of antimicrobial agents. Pediatrics 1998; 101 Suppl:S178-81.
Rosenstein N, Phillips WR, Gerber MA, et al. The common coldprinciples of judicious use of antimicrobial agents. Pediatrics 1998; 101 Suppl:S181-4.
Landrine H, Klonoff EA. Cultural diversity and health psychology. In: Baum A, Revenson T, Singer JE, eds. Handbook of Health Psychology. Mahwah, NJ: Lawrence Erlbaum Associates, 2001; 851-91.