A survey of knowledge, attitudes and practices concerning antibiotic prescription for upper respiratory tract infections among pediatricians in 2018 in Shaanxi Province, China

ABSTRACT

Objective: The objective of this study was to explore the knowledge, attitudes, and practices concerning antibiotic prescriptions to children with URTIs among pediatricians and to identify barriers to appropriate antibiotic prescription among pediatricians.

Methods: An online-based survey was conducted among pediatricians in Shaanxi province, western China, with a population of 38.35 million and an area of 205,600 square kilometers.

Results: A total of 472 pediatricians completed this survey, with the response rate of 26.0%. The theoretical knowledge about antibiotics was excellent, with a median score of 8(0–8). However, 30.1% of the respondents still believed that antibiotics are anti-inflammatory drugs. The pediatricians’ age, education level, and monthly income and whether had ever received training had significant associations with their knowledge level. The attitude scores were 41.1 ± 3.6, with a ranged of 29–52 points (total score of 55), indicating that most respondents had positive attitudes toward antibiotics. However, 22.7% of the respondents still preferred to use antibiotics for URTIs. It was found that uncertain diagnosis, parent requirements and insufficient time were barriers to appropriate antibiotic prescription. The indiscriminate prescription of antibiotics to children with URTIs was prevalent among pediatricians.

Conclusion: Effective integrated interventions should be developed to promote the prudent use of antibiotics among pediatricians.

KEYWORDS:

• Antibiotic
• pediatricians
• knowledge
• attitudes and practices
• China

Article highlights

• It’s time to curb the inappropriate prescription of antibiotics for children with URTIs by pediatricians in China. The first step to promote rational prescription of antibiotics by pediatricians is to understand that influence his prescription behavior.

• The theoretical knowledge about antibiotics was excellent and most of the respondents had positive attitudes towards antibiotics, indiscriminate prescription of antibiotics to children with URTIs was prevalent among pediatricians.

• The pediatricians’ knowledge and attitudes do not always predict their prescription behavior.

• It was found that uncertain diagnosis, parent requirements and insufficient time were barriers to appropriate antibiotic prescription.

• It is not enough to improve the prescription behavior of pediatricians only by training them with knowledge, integrated interventions for pediatricians should be established to promote prudent use of antibiotics in the health institutes.

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.

Reviewer disclosures

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

Additional information

Funding

This work was funded by the National Natural Science Foundation of China (grant number 71603199), the key research and development planning project of Shaanxi province (2018SF-018), and the key research and development planning project of Shaanxi province (2019SF-198). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.