Current Attitudes Regarding Use of Antimicrobial Agents: Results from Physicians' and Parents' Focus Group Discussions

Abstract

Antibiotics are widely prescribed for children with nonspecific upper respiratory tract infections, contributing to the recent emergence of resistant pneumococci. To understand the reasons for the overprescription of antibiotics, we conducted focus groups with parents and with pe-diatricians and family physicians to assess their attitudes regarding the use of antibiotics. Physicians asserted that their own antibiotic prescribing could be safely reduced. Parental expectation to receive antibiotics was a major factor influencing their overuse of antibiotics. Parents indicated that they would be satisfied with the medical visit even if antibiotics were not prescribed, provided the physician explained the reasons for the decision. This study highlights differences in physician and parent perceptions about antibiotic overuse and suggests that educational efforts to narrow this communication gap will be important for improving antibiotic use.

Get full access to this article

View all access options for this article.

References

1. Cohen M . Epidemiology of drug resis-tance: implications for a post-antimi-crobial era. Science. 1992;257:1050-1055.

2. Jernigan D , Cetron M , Breiman R . Minimizing the impact of drug resis-tant Streptococcus pneumoniae (DRSP): a strategy from the DRSP working group. JAMA. 1996;275:206-209.

3. McCaig L , Hughes J . Trends in an-timicrobial drug prescribing among office-based physicians in the United States. JAMA. 1995;273:214-219.

4. Paradise J . Managing otitis media: a time for change. Pediatrics. 1995;96:712-715.

5. The American Society for Microbiol-ogy . Report of the ASM Task Force on An-tibiotic Resistance. Washington, DC: 1995.

6. Centers for Disease Control and Prevention . Drug resistant Streptococcus pneumoniae Kentucky and Ten-nessee, 1993. MMWRR 1994;43:23-25, 31-31.

7. Kreuger R . Focus Groups: a Practical Guide for Applied Research, 2nd ed. New-bury Park, CA: Sage Publications; 1994.

8. Bogdan R , Biklen S . Qualitative Re-search for Education, An Introduction to Theory and Methods. New York: Allyn and Bacon; 1992:153-181.

9. Mayefsky J , El-Shinaway Y , Kellerher P . Families who seek care for the com-mon cold in a pediatric emergency department. J Pediatr. 1991;119:933-934.

10.

10. Shaffner W , Ray W , Federspiel C , Miller W . Improving antibiotic pre-scribing in office practice: a con-trolled trial of three educational methods. JAMA. 1983;250:1728-1732.

11.

11. Molstad S , Ekedahl A , Hovelius B , Thimansson H . Antibiotic prescrip-tion in primary care: a 5-year follow-up of an educational programme. Fam Pract. 1994;11:282-286.

12.

12. Ochoa E , Perez L , Gonzales J , et al. Prescription of antibiotics for mild acute respiratory infections in chil-dren. Bull Pan Am Health Org. 1996;30:106-117.

13.

13. Stewart E , Shamdasani P . Focus Groups Theory and Practice, Applied Social Research Methods Series, vol. 20, New-bury Park, CA: Sage Publications; 1990.

14.

14. Conan P . Patient satisfaction with an office visit for the common cold. JFam Pract. 1987;24:412-413.

15.

15. Hamm R , Hicks R . Bemben D. Antibi-otics and respiratory infections: are patients more satisfied when expecta-tions are met? JFam Pract. 1996;43:56-62.

16.

16. Roberts C , Imprey P , Turner J , et al. Reducing physician visits for colds, through consumer education. JAMA. 1983;250:1986-1989.

17.

17. Stephenson J . Icelandic researchers are showing the way to bring down rates of antibiotic-resistant bacteria. JAMA. 1996;275:175-175.

18.

18. Geller G , Holtzman N . A qualitative assessment of primary care physi-cians' perceptions about the ethical and social implications of offering ge-netic testing. Qual Health Res. 1995;5:97-116.

19.

19. Murphree D . Patient attitudes toward physician treatment of obesity. J Fam Pract. 1994;38:35-38.

20.

20. Schwartz B , Bell D , Hughes J . Prevent-ing the emergence of antimicrobial resistance. A call for action by clini-cians, public health officials, and pa-tients [editorial; comment]. JAMA. 1997;278:944-945.