Parental use and misuse of antibiotics: Are there differences in urban vs. suburban settings and is it a significant contributing factor in antibiotic resistance?
Updated: Sep 11
Author: Edwards DJ, Richman P, Bradley K, Eskin B, Mandell M
Acad Emerg Med. 2002 Jan;9(1):22-6.
Objective: To compare the prevalence of parental misuse of antibiotics (Abx) in a suburban vs. urban setting.
Methods: Prospective survey in a suburban ED in New Jersey (NJ) with 60,000 annual visits and an urban ED in Connecticut (CT) with 58,000 visits. Patients (pts) with children < 18 years of age were consecutively enrolled only during hours when research associates were available. Pts who were critically ill and/or not oriented were excluded. Subjects provided written answers to a series of closed questions regarding their knowledge and use of Abx for their children over the previous 12 months. Categorical data were analyzed by chi-square and Fischer's exact test; continuous data were analyzed by t-tests. All tests were two-tailed, alpha set at 0.05. The primary endpoint, Abx misuse, was defined as parental administration of Abx to a child during the previous 12 months without the consultation of a physician.
Results: 801 prts were enrolled, 424 at NJ. Parents in NJ were significantly different with regard to mean age (39 +/- 7.2 vs. 32 +/- 9.0, p < 0.001 ) % female sex (63% vs. 79%, p < 0.001 ) Caucasian (78% vs. 34%, p, 0.001), and % with private insurance (89% vs. 56%, p < 0.001 ) A greater percentage of prt in NJ had misused Abx (12.1% vs. 4.0%; p < 0.001 ) Using logistic regression, there was still a significant difference in the rate of Abx misuse between the two groups when we adjusted for demographic variables and insurance status of the prt (p < 0.04) There was a large difference in the % of prt in each group who had been discharged from an ED without Abx, only to go to another health facility in order to obtain Abx for their children (5% vs. 48%; p< 0.001).
Conclusion: We found that parents in the suburban setting were more likely to have misused Abx. On the other hand, prt in the urban setting were more likely to have left an ED from which they were discharged and gone to another health facility to obtain Abx for their children.
