Assessment of parental knowledge, attitudes, and practices regarding rational antibiotic use in children under six with upper respiratory tract infections

INTRODUCTION: This study aimed to assess parental knowledge, attitudes, and practices regarding rational antibiotic use in children under six years of age with upper respiratory tract infections and to examine their associations with sociodemographic factors.
METHODS: A cross-sectional survey was conducted among 399 parents who presented to the Pediatric Emergency Department of Göztepe Training and Research Hospital between February and March 2019. The questionnaire comprised 12 knowledge, 5 attitude, and 3 practice items, and responses were evaluated in relation to sociodemographic characteristics and parents’ awareness of media campaigns on rational antibiotic use.
RESULTS: Parents demonstrated an overall correct response rate of 78%, with accuracy being highest for practice items (89.2%), followed by attitude (84.2%) and knowledge (72.7%) items. Higher educational attainment and household income were significantly associated with better scores, whereas parental age, number of children, and relationship to the patient were not. Although most parents recognized that isolated symptoms such as sore throat, ear pain, or fever do not require antibiotics, nearly half incorrectly believed that antibiotics are indicated for the common cold or purulent nasal discharge. Notably, substantial knowledge gaps persisted even among university-educated parents regarding the appropriate use of antibiotics in streptococcal pharyngitis. Awareness of media campaigns was associated with a modest improvement, equivalent to one additional correct response.
DISCUSSION AND CONCLUSION: Parental knowledge gaps regarding antibiotic use in children remain substantial. Education and income were the strongest predictors of accurate knowledge and attitudes. Strengthening accessible, targeted public education initiatives, particularly for socioeconomically disadvantaged families, is essential to promote rational antibiotic use.

Keywords: Antibiotic, media, parent, upper respiratory tract infection.