Antibiotics are the most frequently prescribed and misused drugs and there are reported concerns about the continuous indiscriminate and excessive use of antibiotics leading to emergence of antibiotic-resistant organisms (McLellan and Gray 2001; Krivoy et al. 2007). The use of antimicrobial agents, especially antibiotics has become a routine practice for the treatment of pediatric illnesses (Ghai and Paul 1988; Summers and Summers B 1986). According to Dowell et al. (1998); Nyquist et al. (1998); Nash et al. (2002) a substantial portion of prescribed antibiotics is considered nonessential, and such prescribing may be due to reasons related to: patients, parents or guardians, or the physicians.
Knowledge and beliefs are social cognitive factors at an individual level that influences health-related behavior, including the behavior of using antibiotics. Knowledge by itself is not enough to change behavior, but does play an important role in shaping beliefs and attitude regarding a particular behavior (Conner and Norman 2005). Therefore, several studies have discussed the reasons associated with antibiotics overuse. These include: attitudes, beliefs, knowledge of antibiotic use (Awad et al. 2005; Chan and Tang 2006; Mitsi et al. 2005), behaviors (Al-Azzam et al. 2007; Sarahroodi et al. 2010), patients’ perceptions regarding patient-doctor interaction, patient satisfaction, and patients’ experience with antibiotics (Mitsi et al. 2005; Crossley et al. 2005). The rationale for educating the public is that knowledge about antibiotic treatment and awareness of antibiotic resistance are thought to influence patient and parent demand for antibiotic prescribing (Vanden Eng et al. 2003). Because of wide cross-national differences in antibiotic use (Deschepper et al. 2008), tailoring of educational interventions requires determination of the needs of the audience in each country. Thus, this study sought to explore the current parental knowledge and attitudes towards antibiotic usage and awareness of antibiotic resistance among children that could serve as baseline data and provide further insight in planning and developing strategies for local health education purposes.
Materials and Methods
Study design and population
A cross-sectional survey was conducted from October 2013 to January 2014 among 500 parents using the validated questionnaire. Parents were attending most frequented pharmacies in Tetovo, Republic of Macedonia. The inclusion criteria were: (1) Adults aged 18 years and over; (2) Parents of children younger than 14 years; (3) aware of the term ‘Antibiotics’. Verbal consent was obtained from all study participants before administering the questionnaire. No personal identifiers were included in the form.
Questionnaire development and structure
This self-administered questionnaire was developed by reviewing relevant literature and questionnaires used previously in similar studies (Panagakou et al. 2009; McNulty et al. 2007; Shehadeh et al. 2012;...