Correlates of parental antibiotic knowledge, demand, and reported use

Ambul Pediatr. 2003 Jul-Aug;3(4):203-10. doi: 10.1367/1539-4409(2003)003<0203:copakd>;2.


Background: Clinicians cite parental misconceptions and requests for antibiotics as reasons for inappropriate prescribing.

Aims: To identify misconceptions regarding antibiotics and predictors of parental demand for antibiotics and to determine if parental knowledge and attitudes are associated with use.

Methods: Survey of parents in 16 Massachusetts communities. Domains included antibiotic-related knowledge, attitudes about antibiotics, antibiotic use during a 12-month period, demographics, and access to health information. Bivariate and multivariate analyses evaluated predictors of knowledge and proclivity to demand antibiotics. A multivariate model evaluated the associations of knowledge, demand, and demographic factors with parent-reported antibiotic use.

Results: A total of 1106 surveys were returned (response rates: 54% and 32% for commercially-insured and Medicaid-insured families). Misconceptions were common regarding bronchitis (92%) and green nasal discharge (78%). Two hundred sixty-five (24%) gave responses suggesting a proclivity to demand antibiotics. Antibiotic knowledge was associated with increased parental age and education, having more than 1 child, white race, and receipt of media information on resistance. Factors associated with a proclivity to demand antibiotics included decreased knowledge, pressure from day-care settings, lack of alternatives offered by clinicians, and lack of access to media information. Among all respondents, reported antibiotic use was associated with younger child age and day-care attendance. Among Medicaid-insured children only, less antibiotic knowledge and tendency to demand antibiotics were associated with higher rates of antibiotic use.

Conclusions: Misconceptions regarding antibiotic use are widespread and potentially modifiable by clinicians and media sources. Particular attention should be paid to Medicaid-insured patients in whom such misconceptions may contribute to inappropriate prescribing.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Analysis of Variance
  • Anti-Bacterial Agents / therapeutic use*
  • Attitude to Health*
  • Child
  • Child, Preschool
  • Drug Utilization
  • Educational Status
  • Health Behavior
  • Health Education
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infant
  • Insurance, Health
  • Linear Models
  • Massachusetts
  • Medicaid
  • Middle Aged
  • Otitis / drug therapy*
  • Parents / education*
  • Parents / psychology*
  • Practice Patterns, Physicians'
  • Predictive Value of Tests
  • Respiratory Tract Infections / drug therapy*
  • Surveys and Questionnaires


  • Anti-Bacterial Agents