Background
Methods
Study area and subjects
Data instrument and collection
Data management and analysis
Ethical consideration
Results
General characteristics of participants
Variables | Central towns no. (%) | Villages no. (%) |
P
|
---|---|---|---|
Total | 481(56) | 373(44) | |
Gender | .141 | ||
Female | 362(75) | 273(73) | |
Male | 119(25) | 100(17) | |
Age of parents, yrs.* | < .001 | ||
≤20 | 10(2) | 14(4) | |
21-30 | 272(58) | 274(74) | |
31-40 | 161(35) | 62(17) | |
>40 | 23(5) | 19(5) | |
Age of children, yrs.* | .004 | ||
<1 (infant) | 213(46) | 212(58) | |
1-6 (preschool) | 231(50) | 149(41) | |
7-12 (elementary) | 16(4) | 6(2) | |
13-15 (junior) | 2(0) | 0(0) | |
Education of parents* | <. 001 | ||
Primary school | 5(1) | 11(3) | |
Secondary school | 142(30) | 229(62) | |
High school | 144(30) | 114(31) | |
College or above | 185(39) | 18(5) | |
Number of children* | <. 001 | ||
One | 296(62) | 171(46) | |
Two | 168(35) | 178(48) | |
Three | 13(3) | 22(6) | |
Medical insurance* | .183 | ||
Social | 415(87) | 336(91) | |
Commercial | 7(2) | 3(1) | |
Social and commercial | 14(3) | 4(1) | |
No insurance | 42(9) | 28(8) |
Parents’ knowledge and attitudes on antibiotic use
Questions | Correct response |
P
| |
---|---|---|---|
Central towns no. (%) | Villages no. (%) | ||
Basic concepts
| |||
1. Antibiotics and anti-inflammatory drugs are the same drugs. | 180(37) | 117(31) | .065 |
2. Antibiotics can cure infections caused by virus. | 102(21) | 77(21) | .841 |
3. Antibiotics should only be obtained with a doctor’ prescription. | 309(64) | 246(66) | .603 |
Indications of antibiotic use
| |||
4. Antibiotics should be administered in all cases, once a child has fever. | 346(72) | 247(66) | .072 |
5. If a child suffers from a cough, running nose, and a sore throat, it will be cured more quickly if he/she receives antibiotic as early as possible. | 264(55) | 162(43) | .001 |
6. In most cases, it is not necessary to treat a common cold with antibiotics. | 360(75) | 241(65) | .001 |
7. Taking antibiotics in advance can protect children from a common cold. | 301(63) | 185(50) | < .001 |
Administration of antibiotics
| |||
8. Administration of multiple antibiotics has better effects than a single one. | 278(58) | 201(54) | .254 |
9. The more expensive the antibiotic, the more effective it will be. | 417(87) | 298(80) | .008 |
10. Antibiotics should be withdrawn as soon as the symptoms disappear. | 191(40) | 137(37) | .375 |
Antibiotic resistance and side effects
| |||
11. Overuse of antibiotics increases the risk of antibiotic resistance. | 326(68) | 212(57) | .001 |
12. Antibiotics do not have side effects. | 361(75) | 239(64) | .001 |
13. Scientists can always produce new antibiotics. | 89(19) | 31(8) | < .001 |
14. It is dangerous to children if pathogens become resistant to antibiotics. | 290(60) | 173(46) | < .001 |
Factors | Crude odds ratio (95% CI) | Adjusted odds ratio* (95% CI) |
---|---|---|
Female | 0.865(0.725-1.031) | 0.879 (0.713-1.084) |
Age of parents (yrs.) | 1.012(0.992-1.032) | 1.012 (0.989-1.037) |
Living in a village | 0.464(0.348-0.618) | 0.777 (0.556-1.085) |
Education level of parents | ||
Primary school | 0.085(0.019-0.386) |
0.089 (0.018-0.426)** |
Secondary school | 0.212(0.147-0.306) |
0.262 (0.170-0.405)** |
High school | 0.408(0.280-0.594) |
0.485 (0.323-0.730)**
|
College or above | Reference | Reference |
With medical insurance | 1.161(0.697-1.932) | 1.105 (0.645-1.893) |
More than one child | 0.582(0.440-0.771) | 0.873 (0.627-1.217) |
Interaction between parents and physicians
Self-medicating children with antibiotics
Reasons | Central towns no. (%) | Villages no. (%) |
P
|
---|---|---|---|
1. I thought that my child’s condition was not serious enough | 162(56) | 131(54) | .728 |
2. Some antibiotics previously prescribed by physicians for the similar symptoms were left over at home. | 92(32) | 80(33) | .718 |
3. It is convenient to purchase antibiotics from retail pharmacies. | 56(19) | 30(12) | .033 |
4. I didn’t have enough money to pay for the hospital visit. | 32(11) | 16(7) | .077 |
5. I didn’t have enough time to visit a pediatrician. | 11(4) | 7(3) | .573 |
Factors | Crude odds ratio (95% CI) | Adjusted odds ratio* (95% CI) |
---|---|---|
Female | 1.078(0.916-1.268) | 1.048(0.867-1.268) |
Age of parents, yrs. | 1.015(0.994-1.036) | 1.005(0.978-1.033) |
Living in villages | 1.207(0.911-1.600) |
1.643(1.108-2.436)** |
Education | ||
Primary school | 0.607(0.218-1.694) | 0.191(0.049-0.754) |
Secondary school | 1.738(1.220-2.476) | 1.072(0.636-1.807) |
High school | 1.260(0.868-1.828) | 1.012(0.619-1.654) |
College or above | Reference | Reference |
Has medical insurance | 1.165(0.707-1.920) | 0.941(0.515-1.719) |
Age of children, yrs. | 1.214(1.106-1.332) |
1.146(1.037-1.266)** |
More than one child | 2.595(1.936-3.479) |
2.174(1.485-3.183)** |
Score of questions on knowledge of antibiotics | 0.956(0.909-1.005) | 1.002(0.938-1.071) |
Believes it is reasonable to self-medicate children with antibiotics. | 2.243(1.608-3.127) | 1.158(0.759-1.768) |
Would be dissatisfied if physicians rejected their request for antibiotics | 1.339(0.918-1.952) | 1.259(0.784-2.023) |
Would follow all the advice from physicians | 0.743(0.562-0.983) |
0.639(0.451-0.906)** |
Once purchased antibiotics without physicians’ prescription | 8.469(5.868-12.222) |
6.264(4.144-9.469)** |
Sometimes, often or always stores antibiotics at home | 4.345(3.230-5.845) |
2.792(1.961-3.975)** |