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Effectiveness of a parental educational intervention in reducing antibiotic use in children: a randomized controlled
James A Taylor1, Tao Sheng C Kwan-Gett, Edward M McMahon
1Child Health Institute, University of Washington, Seattle, USA.
Insights
A parent-focused educational intervention did not reduce antibiotic prescriptions for children with upper respiratory tract infections (URIs). Further strategies are needed to curb common antibiotic use in pediatric care.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Antibiotic overuse in children, particularly for upper respiratory tract infections (URIs), is a significant public health concern.
- Judicious antibiotic use is crucial to combat antimicrobial resistance.
- Parental education is a potential strategy to influence healthcare utilization and prescribing patterns.
Purpose of the Study:
- To evaluate the effectiveness of a parent-focused educational intervention in reducing antibiotic prescriptions for children.
- To assess the impact of the intervention on diagnoses and antibiotic use for otitis media and sinusitis.
Main Methods:
- A placebo-controlled, randomized controlled trial was conducted in primary care pediatric offices.
- Parents of healthy children under 24 months received either an educational intervention (pamphlet and videotape) or control brochures.
- Data on outpatient visits and antibiotic prescriptions were collected over a 12-month period for 499 children.
Main Results:
- The educational intervention did not lead to a significant difference in the number of antibiotic prescriptions between the intervention and control groups.
- No significant differences were observed in the number of visits for URI symptoms, diagnoses of otitis media/sinusitis, or total antibiotic prescriptions per patient.
- Antibiotics were prescribed in 45.9% of visits for URI symptoms, primarily for otitis media and/or sinusitis.
Conclusions:
- Parental educational interventions, as implemented in this study, are not effective in reducing antibiotic prescriptions for common childhood infections.
- High rates of antibiotic prescribing for URIs persist, highlighting the need for alternative strategies.
- Further research is required to identify effective interventions to promote judicious antibiotic use in pediatric populations.
Objective:
To determine whether an educational intervention aimed at parents leads to fewer antibiotic prescriptions for their children.
Design:
Placebo-controlled, randomized controlled trial.
Setting:
Offices of primary care pediatricians who are members of a regional practice-based research network.
Participants:
Healthy children younger than 24 months old enrolled at the time of an office visit.
Interventions:
Parents of study children were randomized to receive either a pamphlet and videotape (featuring one of their child's pediatricians) promoting the judicious use of antibiotics (intervention group) or brochures about injury prevention (control group). A total of 499 eligible children were enrolled, and data on outpatient visits during a 12-month observation period were collected.
Main Outcome Measures:
We compared the number of visits for upper respiratory tract infections (URIs), number of diagnoses and antibiotic prescriptions for otitis media and/or sinusitis and total number of antibiotics per patient among children in the intervention and control groups using Poisson regression analysis, adjusted for clustering into different practices.
Results:
: Data on 4924 visits were reviewed; 28.8% of these visits were because of URI symptoms. The mean number of visits per study patient for URI symptoms was 2.8. Including all visits, the mean number of diagnoses of otitis media in study children was 2.1, mean number of diagnoses of otitis media and/or sinusitis was 2.3 and mean number of antibiotic prescriptions was 2.4; there were no significant differences between children in the intervention and control groups for any of these outcomes. Overall physicians prescribed 1 or more antibiotics during 45.9% of visits for a chief complaint of URI symptoms; 92% of antibiotic usage in children presenting with URI symptoms was for a diagnosis of otitis media and/or sinusitis.
Conclusions:
An educational intervention aimed at parents did not result in a decrease in the number of antibiotic prescriptions in their children. The use of antibiotics among children with URI symptoms was common; other interventions promoting the judicious use of these medications are needed.
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