Education: Teaching Parents to "Do the Right Thing"
"Many parents don't understand that colds and earaches are caused not only by bacteria but also by viral infections which don't respond to antibiotics. Daycare centers will let the kids come back sooner if they're taking oral antibiotics, so parents who need to get back to work plead with us to prescribe medication. Sometimes, when a youngster has an ear infection, it's just easier to write a prescription for an antibiotic, even though you know the child will probably get better without it", says one New York pediatrician who prefers not to be identified.
What's the best way to increase parents' knowledge about the growing problem of antibiotic-resistant bacteria, and about the appropriate usage of antibiotics such as Amoxicillin (Amoxil, Trimox and other generic drugs), azithromycin (Zithromax), amoxicillin and clavulanate (Augmentin), and clarithromycin (Biaxin)?
A study supported by the Agency for Healthcare Research and Quality and reported in Pediatrics, randomly divided 206 parents at an urban primary care clinic and a suburban pediatric practice into two groups. Parents in one group were asked to view a 20-minute video about the appropriate use of antibiotics, and were also given a brochure to read. Parents in the control group neither viewed the video nor received a brochure. When interviewed by phone two months later, the "educated" parents were only slightly more knowledgeable about antibiotic usage and misuse than those in the control group, and their self-reported behavior and beliefs had not been significantly affected by their newly acquired knowledge.
These results showed that the use of a brochure and video had only a modest effect on parents' knowledge, beliefs, and behaviors, leading the researchers to conclude that for greatest effectiveness, any campaign promoting the judicious use of oral antibiotics must use a mutlifaceted approach targeted to both parents and healthcare providers.
Another study, which looked at urban and subruban usage of antibiotics by New Jersey parents who had children under age eighteen, found that more than one third of antibiotics used inappropriately were given to children with sore throats, and more than ten percent were given for earaches. Although suburban parents in the study were more likely to misuse antibiotics than their urban counterparts, urban parents who had visited an emergency room were more likely to seek antibiotics at another doctor's office or emergency department.
The results of the study, which was reviewed in the January 2002 issue of Academic Emergency Medicine, confirmed the widespread misuse of antibiotics for children, but ended on an optimistic note, stating that, "Physicians in both office and emergency department settings should explain the rationale behind their use and nonuse of antibiotics in each case. With such parent education, we believe that parents can be influenced to avoid inappropriate use of antibiotics and discouraged from seeking antibiotics in another setting."