Parental self-medication with antibiotics in Iran
AbstractBackground: Parents behavior is an important factor to reduce self-medication, which not only affects health outcomes negatively but also influences health economy. In the present study, parents behavior regarding self-medication using antibiotics for children and its relation to their social status, especially education, are studied in primary schools.Methods: A cross-sectional descriptive analysis was performed using a self-administered anonymous questionnaire.Results: 600 anonymous questionnaires were distributed among the children’s parents in primary schools in Tehran, Iran, and 62.0% of which were returned. Responses showed that 11.1% of parents did not visit a physician to treat their children seasonal cold, while about half of them did self-medication. Furthermore, 52.8% of those who had visited a doctor in the first seasonal disease of their children did not refer again in next events and just refilled their last prescription. In addition, the results of this study indicated significant correlation between self-medication and mothers' education (P < 0.05); that means mothers with higher education had higher rates of physician visits.Conclusion: Mothers' education and health literacy are main factors in the rational use of medicines in children and should be addressed by policy makers in public health training programs.
(1) Schorling JB, De Souza MA, Guerrant RL. Patterns of antibiotic use among children in an urban Brazilian slum. Int J Epidemiol 1991; 20(1): 293-9.
(2) Bi P, Tong S, Parton KA. Family self-medication and antibiotics abuse for children and juveniles in a Chinese city. Soc Sci Med 2000; 50(10): 1445-50.
(3) Sabuncu E, David J, Bernede-Bauduin C, Pepin S, Leroy M, Boelle PY, et al. Significant reduction of antibiotic use in the community after a nationwide campaign in France,
-2007. PLoS Med 2009; 6(6): e1000084.
(4) Neu HC. The crisis in antibiotic resistance. Science 1992; 257(5073): 1064-73.
(5) Avorn J, Solomon DH. Cultural and economic factors that (mis)shape antibiotic use: The nonpharmacologic basis of therapeutics. Ann Intern Med 2000; 133(2): 128-35.
(6) Martinez FD, Holt PG. Role of microbial burden in aetiology of allergy and asthma. Lancet 1999; 354 (Suppl 2): SII12-SII15.
(7) Braun-Fahrlander C, Riedler J, Herz U, Eder W, Waser M, Grize L, et al. Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med 2002; 347(12): 869-77.
(8) McCaig LF, Besser RE, Hughes JM. Trends in antimicrobial prescribing rates for children and adolescents. JAMA 2002; 287(23): 3096-102.
(9) Nyquist AC, Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA 1998; 279(11): 875-7.
(10) Barden LS, Dowell SF, Schwartz B, Lackey C. Current attitudes regarding use of antimicrobial agents: Results from physician's and parents' focus group discussions. Clin Pediatr (Phila) 1998; 37(11): 665-71.
(11) Del Fiol FS, Lopes LC, Barberato-Filho S, Motta CC. Evaluation of the prescription and use of antibiotics in Brazilian children. Braz J Infect Dis 2013; 17(3): 332-7.
(12) Zolaly MA, Hanafi MI. Factors affecting antibiotics prescription in general pediatric clinics. Journal of Taibah University Medical Sciences 2011; 6(1): 33-41.
(13) Tenaiji A, Al Redha K, Khatri F, Hashmey RH. Knowledge, attitudes and behavior towards antibiotic use among parents in Al-Ain City, United Arab Emirates. Int J
Infect Dis 2008; 12(1): e434.
(14) Hare ME, Gaur AH, Somes GW, Arnold SR, Shorr RI. Does it really take longer not to prescribe antibiotics for viral respiratory tract infections in children? Ambul Pediatr 2006; 6(3): 152-6.
(15) Friedman BC, Schwabe-Warf D, Goldman R. Reducing inappropriate antibiotic use among children with influenza infection. Can Fam Physician 2011; 57(1): 42-4.
(16) Huang SS, Rifas-Shiman SL, Kleinman K, Kotch J, Schiff N, Stille CJ, et al. Parental knowledge about antibiotic use: Results of a cluster-randomized, multicommunity intervention. Pediatrics 2007; 119(4): 698-706.
(17) Zwar N, Henderson J, Britt H, McGeechan K, Yeo G. Influencing antibiotic prescribing by prescriber feedback and management guidelines: A 5-year follow-up. Fam Pract 2002; 19(1): 12-7.
(18) Plachouras D, Antoniadou A, Giannitsioti E, Galani L, Katsarolis I, Kavatha D, et al. Promoting prudent use of antibiotics: The experience from a multifaceted regional campaign in Greece. BMC Public Health 2014; 14: 866.
(19) Richman PB, Garra G, Eskin B, Nashed AH, Cody R. Oral antibiotic use without consulting a physician: A survey of ED patients. Am J Emerg Med 2001; 19(1): 57-60.
(20) Kuzujanakis M, Kleinman K, Rifas-Shiman S, Finkelstein JA. Correlates of parental antibiotic knowledge, demand, and reported use. Ambul Pediatr 2003; 3(4): 203-10.
(21) 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): 373-80.
(22) Hong JS, Philbrick JT, Schorling JB. Treatment of upper respiratory infections: Do patients really want antibiotics? Am J Med 1999; 107(5): 511-5.