Parental knowledge, attitudes and practices regarding antibiotic use for acute upper respiratory tract infections in children: a cross-sectional study in Palestine

Background: In primary health care centres, upper respiratory tract infections (URTIs) in children are commonly encountered by physicians. Viruses cause most URTIs, but parents' attitudes often represent an important reason for antibiotic abuse, which leads to the development and spread of antimicrobial resistance. The goal of this study was to examine parents' knowledge, attitudes, and practices (KAP) about antibiotic use for children with URTIs in Palestine. Methods: A cross-sectional study was performed in primary health care centres in Nablus city from 1 June to 31 October 2012. A questionnaire was developed and administered to determine parents' KAP regarding antibiotic use for their children with URTIs. Results: Three hundred and eighty-five parents completed the questionnaire. A total of 79.7 % of the parents were attentive to the truth that antibiotic misuse is responsible for bacterial resistance. Only 18.9 % of parents thought that antibiotics did not have any harmful side effects. Fifty nine per cent of parents did not agree that URTIs are mostly viral in origin and are self-limited. Almost 73 % of parents choose antibiotics as a treatment for URTIs, while earache (68 %) and fever (64 %) were the most common reasons for which parents expected antibiotics. However, more than 38 % of the parents never asked the paediatrician to prescribe antibiotics, and only 6 % congratulated their paediatricians for not prescribing antibiotics. Conclusions: Although there is a trusted relationship between parents and paediatricians, Palestinian parents have insufficient knowledge related to antibiotic use for URTIs in children, which results in inappropriate attitudes and practices. Educational interventions for both parents and physicians will reduce unnecessary antibiotic use and resistance.