206. What Parents Think About Antibiotics for Their Child’s Acute Respiratory Tract Infection
Session: Poster Abstract Session: Antimicrobial Stewardship: Current State and Future Opportunities
Thursday, October 8, 2015
Room: Poster Hall

Parent demand is often cited as a reason for why pediatricians overuse antibiotics. However, we know little about how parents perceive the risks and benefits of antibiotics. The objective of this study was to examine parent perceptions of antibiotics for the treatment of their child’s acute respiratory tract infection (ARTI).


We interviewed parents of children presenting with ARTI symptoms to practices in a large pediatric primary care network. Interviews were conducted before the physician saw the child. The semistructured interview guide included both open- and closed-ended questions. Data were analyzed using a modified grounded theory approach in NVivo 10. 


We interviewed 109 parents from 4 socioeconomically diverse practices from March-June 2014. No parents said that they planned on asking for antibiotics and instead were more concerned with gaining clarity about what was wrong with their child. The majority of parents trusted their physician to suggest the correct therapy and deferred to medical expertise about whether an antibiotic was needed. Most parents said they wanted an antibiotic for their child “only when absolutely necessary.” When asked about their overall thoughts about antibiotics, the majority of parents did not have a strong opinion. Many suggested that they perceived antibiotics to be effective and work quickly. Some parents expressed wariness about overusing antibiotics, knew about resistance and adopted a minimalist approach when it came to giving any medication to their child. When presented with possible side effects of antibiotics and asked to indicate their level of concern, parents were most concerned about their child developing an upset stomach (60% selected “worried”), having an allergic reaction (59% worried), becoming colonized with a drug resistant organism (55% worried) and having diarrhea (53% worried). 


The parents we interviewed did not plan to demand an antibiotic for their child and deferred to medical expertise about the need for antibiotic therapy, contrary to what pediatricians report. This qualitative study suggests that parents are aware of the downsides of antibiotics and may be willing to partner to improve appropriate use.

Julia E. Szymczak, PhD1, Sarah B. Klieger, MPH2, Neika Vendetti, MPH3, Matthew Miller, B.S.4, Alexander Fiks, MD, MSCE4 and Jeffrey S. Gerber, MD, PhD2, (1)Division of Infectious Diseases, Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA, (2)Department of Pediatrics, Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA, (3)Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA, (4)The Children's Hospital of Philadelphia, Philadelphia, PA


J. E. Szymczak, None

S. B. Klieger, None

N. Vendetti, None

M. Miller, None

A. Fiks, None

J. S. Gerber, None

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