Parents' and physicians' views on antibiotics.

OBJECTIVE To describe parents' opinions and concerns about antibiotics and to contrast these opinions with those of pediatricians. DESIGN Parents were surveyed using an interviewer-administered questionnaire and pediatricians were mailed a self-administered questionnaire. RESULTS Parents from two private practices (N = 300) were largely white (84%) and had completed college (81%). The parents from a community health center (N = 100) were mostly black (80%) and had not completed college (91%). Twenty-nine percent of parents were worried that their children were receiving too many antibiotics. Eighty-five percent believed there were problems with receiving too many antibiotics, with 55% mentioning resistance or immunity as concerns. Eighteen percent of parents had given their child an antibiotic at home before consulting a physician. Parents believed that antibiotics were always or sometimes required for ear infections (93%), throat infections (83%), colds (32%), cough (58%), and fever (58%). Fourteen percent of parents believed that their child had required an antibiotic when the doctor did not prescribe one, with clinic parents significantly more likely to report this issue (22%) than private practice parents (12%). Nine percent believed that their doctor had prescribed an antibiotic unnecessarily (private practice = 12%, community health center = 3%). Parents from the private practices were also more likely to report requesting a specific antibiotic (34%) in comparison with 19% of clinic parents. Sixty-one percent of the physician surveys were returned after two mailings and a follow-up phone call. The pediatricians had been in practice for a median of 12 years, seeing a median of 110 patients per week. Fifty-eight percent of pediatricians reported that some, many, or most of the parents in their practices were worried that their children were receiving too many antibiotics. Seventy-one percent indicated that four or more times during the previous month, a parent had requested an antibiotic when the physician believed it was unnecessary, and 35% said that at least occasionally they went along with these requests. Sixty-one percent reported that parents requested a different antibiotic from the one they were going to prescribe at least four times in the previous month, and 30% of pediatricians said that they agreed to parents' requests often or most of the time. CONCLUSIONS Both the parent and the physician surveys suggest that parents are concerned about the overuse of antibiotics, but often request them when their physicians believe they are unnecessary. Parents often administer antibiotics without physician knowledge, and many parents have misconceptions about which illnesses warrant antibiotic therapy. Understanding parents' concerns and beliefs about antibiotics and the range of physician practice styles with respect to antibiotics may direct the development of intervention strategies to reduce the inappropriate use of oral antibiotics.