Non-prescription use of antibiotics among children in urban China: a cross-sectional survey of knowledge, attitudes, and practices

ABSTRACT

Background: Non-prescription use of antibiotics in children is an important public health problem. We aimed to investigate primary caregivers’ knowledge, attitudes, and practices of antibiotics use among children in urban China.

Methods: Knowledge, attitudes, and practices regarding antibiotics use in children were assessed through a cross-sectional questionnaire survey of 4200 caregivers of children under-7 years from three cities in China. Data were analyzed using descriptive statistics and multivariate analysis.

Results: Caregivers’ knowledge gaps and undesirables attitudes regarding appropriate use of antibiotics were identified. 48.2% of respondents reported non-prescription use of antibiotics for children in the past 6 months. The most common sources of antibiotics used without a prescription are community pharmacies and leftovers. Storing antibiotics at home and caregivers’ supportive attitude were positively and significantly associated with non-prescription use of antibiotics in children, while significant inverse associations were found for caregiver’s knowledge of prescription-only regulation on antibiotics sales at community pharmacies.

Conclusions: There was a high proportion of primary caregivers self-medicate antibiotics for children in urban China, despite their insufficient knowledge about antibiotic use. Public health initiatives are needed such as public education campaigns and stricter government regulation of antibiotic use and availability in community pharmacies.

KEYWORDS:

• Antibiotics
• KAP
• medicating children
• self-medication
• urban China

Acknowledgments

We especially thank the questionnaire respondents who kindly devoted their time to the study. We also thank Amy Page, Dan Luo, Jianglin Zhang, Qing Gong, Jing Hu, Yingzhen Liang, Ping Zhou, Jun Liu, Lina Liu, Sheng Wang, Shuang Du, Xiaoyan Pang and Qiulan Zhu who helped perform the survey.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Authors’ contributions

YF, JC, and BL conceived and designed the study; JC did the statistical analyses; JC and BL did the analysis of the literature, interpreted the results and wrote the article; BL, SZ, DY, JY, YZ, and KY participated in the data collection; YF coordinated and supervised the data collection, and critically reviewed the manuscript. MMA and CY contributed to the interpretation of results and revision. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Ethics approval and consent to participate

This study was approved by Ethics Committee of Xi’an Jiaotong University Health Science Center. In this study, written informed consent was obtained from all the participants.

Additional information

Funding

This study was financially supported by the ‘Young Talent Support Plan’ of Xian Jiaotong University, the Fundamental Research Funds for the Central Universities (2015qngz05), the China Medical Board Open Competition Program (grant number 14-196), and the China Postdoctoral Science Foundation (grant numbers 2015M580862, 2016T90935).