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Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | Antibiotic | Research

Knowledge, attitudes and practices of parents towards antibiotic use in rural communities in Peru: a cross-sectional multicentre study

Authors: Jose Luis Paredes, Rafaella Navarro, Takashi Watanabe, Flavia Morán, Maria Pia Balmaceda, Andrea Reateguí, Raul Elias, Miguel Bardellini, Theresa J. Ochoa

Published in: BMC Public Health | Issue 1/2022

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Abstract

Background

The inappropriate use of antibiotics significantly contributes to the development of antibiotic resistance. There is limited information about the use of antibiotics among parents from rural areas in Peru. This study aimed to describe the knowledge, attitudes and practices towards antibiotics among parents of children < 5 years of age from rural communities in Peru; to explore the association between knowledge and attitudes towards antibiotics and to explore determinants of low knowledge and self-medicating his/her child with antibiotics.

Methods

Cross-sectional study in six rural primary health centres in Peru using a self-administered survey. Crude and adjusted Prevalence Ratios (PR), and 95% Confidence Intervals (95% CI) were calculated to explore determinants of low knowledge and of having self-medicated his/her child with antibiotics. Linear regression was used to explore the association between knowledge and attitudes.

Results

A total of 231 parents were included. The largest gap in knowledge was among 183 parents (79%) who did not know that antibiotics cannot cure viral infections. The largest gap in attitudes was among 185 participants (80%) that did not disagree with “If I want my child to receive antibiotics, I would not be satisfied if the doctor refuses to prescribe them”. More than half of parents (n = 120, 52%) reported having self-medicated his/her child with antibiotics. A positive correlation was found between knowledge and attitudes (Coefficient 0.53, 95% CI 0.38–0.68) after adjusting for the age and the education of the parent. Parents who were < 20 years old were more likely to have low knowledge about antibiotics (crude PR 2.39, 95% CI 1.32–4.34) compared to those aged > 40 years.
Parents who had self-medicated his/her child with antibiotics (n = 120, 52%) were more likely to have purchased antibiotics without prescription (aPR 2.70, 95% CI 1.74–4.19) and to have received antibiotics after the recommendation of a pharmacist (aPR 1.79, 95% CI 1.13–2.82).

Conclusions

Knowledge about antibiotics among parents from rural settings in Peru is limited and highlights the need for educational interventions. Public health policies to limit the acquisition of antibiotics without prescription should be implemented.
Literature
4.
go back to reference Cars O. Reacting to antimicrobial resistance. Bull World Health Organ. 2019;97:384–5.CrossRef Cars O. Reacting to antimicrobial resistance. Bull World Health Organ. 2019;97:384–5.CrossRef
5.
go back to reference Klein EY, Van Boeckel TP, Martinez EM, Pant S, Gandra S, Levin SA, et al. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proc Natl Acad Sci U S A. 2018;115:E3463–70.PubMedPubMedCentral Klein EY, Van Boeckel TP, Martinez EM, Pant S, Gandra S, Levin SA, et al. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proc Natl Acad Sci U S A. 2018;115:E3463–70.PubMedPubMedCentral
7.
go back to reference Paredes JL, Navarro R, Riveros M, Picon V, Conde F, Suito-Ferrand M, et al. Parental antibiotic use in urban and Peri-urban health care centers in Lima: a cross-sectional study of knowledge, attitudes, and practices. Clin Med Insights Pediatr. 2019;13:1179556519869338.CrossRef Paredes JL, Navarro R, Riveros M, Picon V, Conde F, Suito-Ferrand M, et al. Parental antibiotic use in urban and Peri-urban health care centers in Lima: a cross-sectional study of knowledge, attitudes, and practices. Clin Med Insights Pediatr. 2019;13:1179556519869338.CrossRef
8.
go back to reference Ecker L, Ochoa TJ, Vargas M, Del Valle LJ, Ruiz J. Preferences of antibiotic use in children less than five in physicians working health centers of primary level in peri-urban areas of Lima, Peru. Rev Peru Med Exp Salud Publica. 2013;30:181–9.PubMed Ecker L, Ochoa TJ, Vargas M, Del Valle LJ, Ruiz J. Preferences of antibiotic use in children less than five in physicians working health centers of primary level in peri-urban areas of Lima, Peru. Rev Peru Med Exp Salud Publica. 2013;30:181–9.PubMed
9.
go back to reference Yu M, Zhao G, Stålsby Lundborg C, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis. 2014;14:112.CrossRef Yu M, Zhao G, Stålsby Lundborg C, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis. 2014;14:112.CrossRef
10.
go back to reference Cantarero-Arévalo L, Hallas MP, Kaae S. Parental knowledge of antibiotic use in children with respiratory infections: a systematic review. Int J Pharm Pract. 2017;25:31–49.CrossRef Cantarero-Arévalo L, Hallas MP, Kaae S. Parental knowledge of antibiotic use in children with respiratory infections: a systematic review. Int J Pharm Pract. 2017;25:31–49.CrossRef
11.
go back to reference García C, Horna G, Linares E, Ramírez R, Tapia E, Velásquez J, et al. Antimicrobial Drug Resistance in Peru. Emerg Infect Dis. 2012;18:520–1.CrossRef García C, Horna G, Linares E, Ramírez R, Tapia E, Velásquez J, et al. Antimicrobial Drug Resistance in Peru. Emerg Infect Dis. 2012;18:520–1.CrossRef
12.
go back to reference Ecker L, Ruiz J, Vargas M, Del Valle LJ, Ochoa TJ. Prevalence of purchase of antibiotics without prescription and antibiotic recommendation practices for children under five years of age in private pharmacies in peri-urban areas of Lima, Peru. Rev Peru Med Exp Salud Publica. 2016;33:215–23.CrossRef Ecker L, Ruiz J, Vargas M, Del Valle LJ, Ochoa TJ. Prevalence of purchase of antibiotics without prescription and antibiotic recommendation practices for children under five years of age in private pharmacies in peri-urban areas of Lima, Peru. Rev Peru Med Exp Salud Publica. 2016;33:215–23.CrossRef
13.
go back to reference Alzamora MC, Echevarría AC, Ferraro VM, Riveros MD, Zambruni M, Ochoa TJ. Antimicrobial resistance of commensal Escherichia coli strains in children of two rural communities in Peru. Rev Peru Med Exp Salud Publica. 2019;36:459–63.CrossRef Alzamora MC, Echevarría AC, Ferraro VM, Riveros MD, Zambruni M, Ochoa TJ. Antimicrobial resistance of commensal Escherichia coli strains in children of two rural communities in Peru. Rev Peru Med Exp Salud Publica. 2019;36:459–63.CrossRef
14.
go back to reference Kristiansson C, Reilly M, Gotuzzo E, Rodriguez H, Bartoloni A, Thorson A, et al. Antibiotic use and health-seeking behaviour in an underprivileged area of Perú: health-seeking in a poor area of Peru. Tropical Med Int Health. 2008;13:434–41.CrossRef Kristiansson C, Reilly M, Gotuzzo E, Rodriguez H, Bartoloni A, Thorson A, et al. Antibiotic use and health-seeking behaviour in an underprivileged area of Perú: health-seeking in a poor area of Peru. Tropical Med Int Health. 2008;13:434–41.CrossRef
16.
go back to reference Alili-Idrizi E, Dauti M, Malaj L. Validation of the parental knowledge and attitude towards antibiotic usage and resistance among children in Tetovo, the republic of Macedonia. Pharm Pract (Granada). 2014;12:467.CrossRef Alili-Idrizi E, Dauti M, Malaj L. Validation of the parental knowledge and attitude towards antibiotic usage and resistance among children in Tetovo, the republic of Macedonia. Pharm Pract (Granada). 2014;12:467.CrossRef
17.
go back to reference Nepal A, Hendrie D, Robinson S, Selvey LA. Knowledge, attitudes and practices relating to antibiotic use among community members of the Rupandehi District in Nepal. BMC Public Health. 2019;19:1558.CrossRef Nepal A, Hendrie D, Robinson S, Selvey LA. Knowledge, attitudes and practices relating to antibiotic use among community members of the Rupandehi District in Nepal. BMC Public Health. 2019;19:1558.CrossRef
18.
go back to reference Zahreddine L, Hallit S, Shakaroun S, Al-Hajje A, Awada S, Lahoud N. Knowledge of pharmacists and parents towards antibiotic use in pediatrics: a cross-sectional study in Lebanon. Pharm Pract (Granada). 2018;16:1194.CrossRef Zahreddine L, Hallit S, Shakaroun S, Al-Hajje A, Awada S, Lahoud N. Knowledge of pharmacists and parents towards antibiotic use in pediatrics: a cross-sectional study in Lebanon. Pharm Pract (Granada). 2018;16:1194.CrossRef
19.
go back to reference Torres NF, Chibi B, Middleton LE, Solomon VP, Mashamba-Thompson TP. Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review. Public Health. 2019;168:92–101.CrossRef Torres NF, Chibi B, Middleton LE, Solomon VP, Mashamba-Thompson TP. Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review. Public Health. 2019;168:92–101.CrossRef
21.
go back to reference Sirota M, Round T, Samaranayaka S, Kostopoulou O. Expectations for antibiotics increase their prescribing: causal evidence about localized impact. Health Psychol. 2017;36:402–9.CrossRef Sirota M, Round T, Samaranayaka S, Kostopoulou O. Expectations for antibiotics increase their prescribing: causal evidence about localized impact. Health Psychol. 2017;36:402–9.CrossRef
22.
go back to reference Mangione-Smith R, McGlynn EA, Elliott MN, Krogstad P, Brook RH. The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior. Pediatrics. 1999;103:711–8.CrossRef Mangione-Smith R, McGlynn EA, Elliott MN, Krogstad P, Brook RH. The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior. Pediatrics. 1999;103:711–8.CrossRef
28.
go back to reference Bauer J, Müller R, Brüggmann D, Groneberg DA. Spatial accessibility of primary Care in England: a cross-sectional study using a floating catchment area method. Health Serv Res. 2018;53:1957–78.CrossRef Bauer J, Müller R, Brüggmann D, Groneberg DA. Spatial accessibility of primary Care in England: a cross-sectional study using a floating catchment area method. Health Serv Res. 2018;53:1957–78.CrossRef
29.
go back to reference Wilkinson A, Ebata A, MacGregor H. Interventions to reduce antibiotic prescribing in LMICs: a scoping review of evidence from human and animal health systems. Antibiotics. 2018;8:2.CrossRef Wilkinson A, Ebata A, MacGregor H. Interventions to reduce antibiotic prescribing in LMICs: a scoping review of evidence from human and animal health systems. Antibiotics. 2018;8:2.CrossRef
Metadata
Title
Knowledge, attitudes and practices of parents towards antibiotic use in rural communities in Peru: a cross-sectional multicentre study
Authors
Jose Luis Paredes
Rafaella Navarro
Takashi Watanabe
Flavia Morán
Maria Pia Balmaceda
Andrea Reateguí
Raul Elias
Miguel Bardellini
Theresa J. Ochoa
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Antibiotic
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-12855-0

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