Skip to main content
PMC home page
Canadian Family Physician logoLink to Canadian Family Physician
. 2001 Mar;47:521–527.

Prescribing practices and attitudes toward giving children antibiotics.

E Paluck 1, D Katzenstein 1, C J Frankish 1, C P Herbert 1, R Milner 1, D Speert 1, K Chambers 1
PMCID: PMC2018393  PMID: 11281085

Abstract

OBJECTIVE: To investigate whether overprescribing is common in treatment of pediatric upper respiratory infections and to examine factors that influence prescribing antibiotics for children. DESIGN: A random, stratified sample of practising family physicians was surveyed with a mailed questionnaire. Initial nonresponders were mailed a second questionnaire. SETTING: British Columbia. PARTICIPANTS: A total of 608 general and family physicians. Response rate was 64%; 392/612 surveys were completed. MAIN OUTCOME MEASURES: Physicians' self-reported prescribing practices and knowledge of and attitudes toward using antibiotics for children's upper respiratory tract infections. RESULTS: Relative to treatment guidelines developed for the study, most physicians responded appropriately to the cough (94%) and lobar pneumonia (99.1%) vignettes. More than half the physicians (56.5%) reported they would immediately prescribe antibiotics for tympanic membrane dysfunction, and 79.4% indicated they would prescribe antibiotics for pharyngitis without obtaining a laboratory culture. Approximately 25% of physicians in the study did not believe that prior antibiotic use increased personal risk for acquiring drug-resistant infection, and 23.1% did not believe that antibiotic use was an important factor in promoting resistance in their communities. CONCLUSION: Education in current treatment of pediatric upper respiratory tract illnesses and antimicrobial drug resistance is required. The high response to the questionnaire (64%) and the many requests from physicians to receive the project's educational materials (45%) indicate a high level of interest in this subject.

Full Text

The Full Text of this article is available as a PDF (58.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acar J. F. Consequences of bacterial resistance to antibiotics in medical practice. Clin Infect Dis. 1997 Jan;24 (Suppl 1):S17–S18. doi: 10.1093/clinids/24.supplement_1.s17. [DOI] [PubMed] [Google Scholar]
  2. Arnold K. E., Leggiadro R. J., Breiman R. F., Lipman H. B., Schwartz B., Appleton M. A., Cleveland K. O., Szeto H. C., Hill B. C., Tenover F. C. Risk factors for carriage of drug-resistant Streptococcus pneumoniae among children in Memphis, Tennessee. J Pediatr. 1996 Jun;128(6):757–764. doi: 10.1016/s0022-3476(96)70326-8. [DOI] [PubMed] [Google Scholar]
  3. Barden L. S., Dowell S. F., Schwartz B., Lackey C. Current attitudes regarding use of antimicrobial agents: results from physician's and parents' focus group discussions. Clin Pediatr (Phila) 1998 Nov;37(11):665–671. doi: 10.1177/000992289803701104. [DOI] [PubMed] [Google Scholar]
  4. Butler C. C., Rollnick S., Pill R., Maggs-Rapport F., Stott N. Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats. BMJ. 1998 Sep 5;317(7159):637–642. doi: 10.1136/bmj.317.7159.637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Davy T., Dick P. T., Munk P. Self-reported prescribing of antibiotics for children with undifferentiated acute respiratory tract infections with cough. Pediatr Infect Dis J. 1998 Jun;17(6):457–462. doi: 10.1097/00006454-199806000-00004. [DOI] [PubMed] [Google Scholar]
  6. Dowell S. F., Schwartz B. Resistant pneumococci: protecting patients through judicious use of antibiotics. Am Fam Physician. 1997 Apr;55(5):1647-54, 1657-8. [PubMed] [Google Scholar]
  7. Gonzales R., Steiner J. F., Sande M. A. Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA. 1997 Sep 17;278(11):901–904. [PubMed] [Google Scholar]
  8. Hamm R. M., Hicks R. J., Bemben D. A. Antibiotics and respiratory infections: are patients more satisfied when expectations are met? J Fam Pract. 1996 Jul;43(1):56–62. [PubMed] [Google Scholar]
  9. Kaplan E. L., Top F. H., Jr, Dudding B. A., Wannamaker L. W. Diagnosis of streptococcal pharyngitis: differentiation of active infection from the carrier state in the symptomatic child. J Infect Dis. 1971 May;123(5):490–501. doi: 10.1093/infdis/123.5.490. [DOI] [PubMed] [Google Scholar]
  10. Mainous A. G., 3rd, Hueston W. J., Love M. M. Antibiotics for colds in children: who are the high prescribers? Arch Pediatr Adolesc Med. 1998 Apr;152(4):349–352. [PubMed] [Google Scholar]
  11. Mangione-Smith R., McGlynn E. A., Elliott M. N., Krogstad P., Brook R. H. The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior. Pediatrics. 1999 Apr;103(4 Pt 1):711–718. doi: 10.1542/peds.103.4.711. [DOI] [PubMed] [Google Scholar]
  12. McCaig L. F., Hughes J. M. Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA. 1995 Jan 18;273(3):214–219. [PubMed] [Google Scholar]
  13. McIsaac W. J., White D., Tannenbaum D., Low D. E. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998 Jan 13;158(1):75–83. [PMC free article] [PubMed] [Google Scholar]
  14. Nyquist A. C., Gonzales R., Steiner J. F., Sande M. A. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA. 1998 Mar 18;279(11):875–877. doi: 10.1001/jama.279.11.875. [DOI] [PubMed] [Google Scholar]
  15. Pennie R. A. Prospective study of antibiotic prescribing for children. Can Fam Physician. 1998 Sep;44:1850–1856. [PMC free article] [PubMed] [Google Scholar]
  16. Pianosi P., Feldman W., Robson M. G., McGillivray D. Inappropriate use of antibiotics in croup at three types of hospital. CMAJ. 1986 Feb 15;134(4):357–359. [PMC free article] [PubMed] [Google Scholar]
  17. Reichler M. R., Allphin A. A., Breiman R. F., Schreiber J. R., Arnold J. E., McDougal L. K., Facklam R. R., Boxerbaum B., May D., Walton R. O. The spread of multiply resistant Streptococcus pneumoniae at a day care center in Ohio. J Infect Dis. 1992 Dec;166(6):1346–1353. doi: 10.1093/infdis/166.6.1346. [DOI] [PubMed] [Google Scholar]
  18. Schwartz R. H., Freij B. J., Ziai M., Sheridan M. J. Antimicrobial prescribing for acute purulent rhinitis in children: a survey of pediatricians and family practitioners. Pediatr Infect Dis J. 1997 Feb;16(2):185–190. doi: 10.1097/00006454-199702000-00004. [DOI] [PubMed] [Google Scholar]
  19. Vinson D. C., Lutz L. J. The effect of parental expectations on treatment of children with a cough: a report from ASPN. J Fam Pract. 1993 Jul;37(1):23–27. [PubMed] [Google Scholar]
  20. Wang E. E., Kellner J. D., Arnold S. Antibiotic-resistant Streptococcus pneumoniae. Implications for medical practice. Can Fam Physician. 1998 Sep;44:1881–1888. [PMC free article] [PubMed] [Google Scholar]
  21. Witte W. Medical consequences of antibiotic use in agriculture. Science. 1998 Feb 13;279(5353):996–997. doi: 10.1126/science.279.5353.996. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES