Antibiotic overuse in children could be reduced with improved communication

The study's authors found that only 4% of parents advised to delay the use of antibiotics for their children's ear infections recalled receiving comprehensive advice, including information about the infection, the risks of antibiotics, and how to properly care for their children.

Importantly, the study also showed that parents who recalled receiving more detailed explanations from their health care providers were more likely to use antibiotics only if they were truly needed. By waiting to administer antibiotics, parents allow their children the chance to recover naturally.

Lead author Erina L. MacGeorge from Pennsylvania State University explained, "When we use antibiotics, the strongest bacteria still survive even though we feel well again. Over time, these bacteria adapt to become resistant 'superbugs' that even very strong antibiotics with dangerous side effects cannot kill. Our best defense is to avoid antibiotics whenever possible, with guidance from health care professionals."

Previous studies have shown this so-called "watchful waiting" approach to be an effective way to reduce unnecessary antibiotic use without affecting patient safety. However, the findings of this study suggest that parents' compliance with watchful waiting advice could be increased by enhancing physician instruction.

The research study examined 134 U.S. parents of children under five years old who were given antibiotics to administer in case their child's condition failed to improve within a certain timeframe. They were asked to recall their interactions with health care providers and report what they remembered being told to do. They were also asked if they ultimately used the antibiotics.

Review of participants' responses revealed that even when parents reported receiving explanations about the risks of antibiotics, their understanding of what they heard was not necessarily complete or correct. One participant reported, "If children are given antibiotics when it is not necessary, they can build up an immunity to them." However, it's bacteria, not children, that become immune to antibiotics, so the dangers of overuse extend beyond any individual child. This misunderstanding illustrates the challenge of understanding antibiotic resistance, and the need for health care providers to more clearly communicate the dangers of overuse.

According to American Academy of Pediatrics guidelines, parents advised to undertake watchful waiting should receive information from health care providers on the nature of ear infections, adverse effects of antibiotics, how to monitor and manage symptoms such as pain, and when to seek follow-up care.

With antibiotic-resistant infections currently responsible for 50,000 deaths per year in the United States and Europe alone, the results of this study suggest that further research is needed to help combat overuse.