Mj. Trepka et al., The effect of a community intervention trial on parental knowledge and awareness of antibiotic resistance and appropriate antibiotic use in children, PEDIATRICS, 107(1), 2001, pp. NIL_42-NIL_48
Background. Overuse of antibiotics for children's upper respiratory infecti
ons is widespread and contributes to the emergence of antibiotic-resistant
bacteria.
Objective. To assess changes in knowledge and awareness regarding antibioti
c resistance and appropriate antibiotic use after community-wide educationa
l interventions to reduce inappropriate antibiotic use.
Design. Baseline survey conducted during June through July 1997 and postint
ervention survey of baseline participants during June through August 1998.
Setting. Communities in northern Wisconsin.
Participants. Parents of 729 randomly selected children <4 years of age wer
e called until 215 in each of the intervention and control areas were reach
ed. Of the 430 baseline participants, 365 (85%) participated in the postint
ervention survey.
Intervention. Parent-oriented activities included distribution of materials
and presentations. Physician-oriented activities included formal presentat
ions and small group meetings.
Outcome Measure. Change in awareness about antibiotic resistance and knowle
dge about antibiotic indications.
Results. A higher proportion of parents in the intervention area (53%) were
exposed to 2 or more local educational messages, compared with the control
area (23%). From the baseline to the postintervention survey, the percenta
ge of parents with a high degree of antibiotic resistance awareness increas
ed more in the intervention area (58% to 73%) than in the control area (60%
to 65%). In the intervention area, there was also a larger increase in kno
wledge regarding appropriate indications for antibiotic use, compared with
the control area. The proportion of parents who expected an antibiotic for
their child and did not receive one declined in the intervention area (14%
to 9%), while it increased in the control area (7% to 10%). In addition, th
e percentage of parents in the intervention area who brought their child to
another physician because they did not receive an antibiotic decreased (5%
to 2%), while it increased in the control area (2% to 4%).
Conclusion. Parental knowledge and awareness about antibiotic indications a
nd antibiotic resistance can be changed with educational interventions dire
cted at parents and clinicians.