Last month The PediaBlog explored the emerging global crisis of antibiotic resistance (“Antimicrobial Resistance – Part 1” and “Part 2” — January 13-14, 2014). Pediatricians have known for years that the “resistance of a microorganism to an antimicrobial medicine to which it was originally sensitive” (WHO) is a growing and dangerous problem. The American Academy of Pediatrics and other pediatric health organizations sounded the alarm long ago and, for the most part, pediatricians have heeded the warnings by educating not just ourselves, but our patients and families about the need to use antibiotics judiciously. Family medicine and internal medicine doctors have also read the science behind the dangers of microbes — especially bacteria — becoming resistant to the mainstays of treatment. (Probably every primary care physician has a horror story to share regarding patients who suffered from resistant infections.)
Still, you can hear some physicians pushing back, saying they prescribe antibiotics because that is what their patients expect and want. This seems to be a common perception among doctors: “If I don’t prescribe an antibiotic, they’ll go somewhere else — to another doctor or a Doc-in-the-Box — to get one.”
A new study published in this month’s Clinical Pediatrics concludes that this is a mistaken perception — at least among parents of children:
Parental misconceptions and even “demand” for unnecessary antibiotics were previously viewed as contributors to overuse of these agents. We conducted focus groups to explore the knowledge and attitudes surrounding common infections and antibiotic use in the current era of more judicious prescribing. Among diverse groups of parents, we found widespread use of home remedies and considerable concern regarding antibiotic resistance. Parents generally expressed the desire to use antibiotics only when necessary. There was appreciation of inherent error in the diagnosis of common infections, with most trust placed in providers with whom parents had long-standing relationships. While some parents had experience with “watchful waiting” for otitis media, there was little enthusiasm for this approach. While there may still be room for further education, it appears that parents have become more informed and sophisticated regarding appropriate uses of antibiotics. This has likely contributed to the declines seen in their use nationally.
All physicians should continue to use science to inform our patients and families regarding the use of antibiotics (and other medications, vaccines, invasive procedures, and other therapies, treatments, and preventative measures doctors counsel people about). This study tells us that parents seem to learn the most (and trust the most) information they receive from their pediatricians, who themselves are informed by evidence and not intuition or the latest fads.
Pediatricians don’t get through to everyone but it seems like we do make an impact! People do hear us!