Prescribing practices and attitudes toward giving children antibiotics

OBJECTIVE To investigate whether overprescribing is common in treatment of pediatric upper respiratory infections and to examine factors that influenc e prescribing antibiotics for children. DESIGN A random, stratified sample of practising family physicians was surv eyed with a mailed questionnaire. Initial nonresponders were mailed a secon d questionnaire. SETTING British Columbia. PARTICIPANTS A total of 608 general and family physicians. Response rate wa s 64%; 392/612 surveys were completed. MAIN OUTCOME MEASURES Physicians' self-reported prescribing practices and k nowledge of and attitudes toward using antibiotics for children's upper res piratory tract infections. RESULTS Relative to treatment guidelines developed for the study, most phys icians responded appropriately to the cough (94%) and lobar pneumonia (99.1 %) vignettes. More than half the physicians (56.5%) reported they would imm ediately prescribe antibiotics for tympanic membrane dysfunction, and 79.4% indicated they would prescribe antibiotics for pharyngitis without obtaini ng a laboratory culture. Approximately 25% of physicians in the study did n ot 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 tr act illnesses and antimicrobial drug resistance is required. The high respo nse to the questionnaire (64%) and the many requests from physicians to rec eive the project's educational materials (45%) indicate a high level of int erest in this subject.