Self-Medication with Antibiotics Among Children in China: A Cross-Sectional Study of Parents’ Knowledge, Attitudes, and Practices

Abstract

Background

Self-medication with antibiotics (SMA) among children is a common practice in low-income and middle-income countries, which has accelerated antibacterial abuse.

Objective

This study aimed to estimate the prevalence and associated factors of SMA among children in China, including parents’ knowledge, attitudes, and practices towards antibiotic use.

Methods

A cross-sectional study based on a structured questionnaire survey of parents was conducted in Nantong between July and September 2020. A total of 1699 respondents participated. Information on participants’ demographic and family characteristics, knowledge, attitudes, and practices towards antibiotics use was collected. Hierarchical binary logistic regression was used to examine the predictors of SMA among children.

Results

Among 1699 participants, 23.31% practiced SMA to their children in the past year. Cough (59.6%) was the most common symptom leading to self-medication and penicillins (85.4%) were the most commonly used drugs. Hierarchical regression indicated that parents with higher level of antibiotic knowledge scores (OR=1.163, 95% CI: 1.067–1.268) and buying antibiotics without a prescription from pharmacy (OR=1.475, 95% CI: 1.097–1.983) were more likely to practice SMA to their children both in urban and in rural areas. Storing antibiotics at home resulted in an increased likelihood of self-medication in urban areas but not in rural areas. In addition, there was also a higher probability of non-prescribed antibiotics in children without chronic diseases (OR=1.959, 95% CI:1.072–3.578).

Conclusion

The prevalence of SMA in children is high in China. Higher knowledge scores and practices of buying and storing non-prescribed antibiotics behaviors increased parents’ antibiotic self-medication in their children. Practical and effective education intervention for children’s rational use of antibiotics is urgently strengthened.

Keywords:

• antibiotic
• self-medication
• children
• China
• antibiotic knowledge
• attitude

Abbreviations

SMA, self-medication with antibiotics; GDP, Gross Domestic Product; KAP, knowledge, attitude, practice.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

This study was approved by the Ethics Committee of Nantong University. All respondents were aware of the purpose of this study and consented to participate in the survey. Data were collected anonymously. This study was performed in accordance with the Declaration of Helsinki.

Acknowledgments

The authors would like to thank the respondents who participated in this survey.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by National Natural Science Foundation of China [72004104]. The grant agency did not involve in the design of the study, collection, analysis and interpretation of data, and writing or revising the manuscript.