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Perceived parent-pressure causes excessive antibiotic prescription

November 6, 2009 Antibiotic over-prescription is promoted by
pediatricians' perception of parents' expectations. Research published
in the open access journal BMC Pediatrics shows that pediatricians are
more likely to inappropriately prescribe antibiotics for respiratory
tract infections if they perceived parents were expecting a

Researchers from the Agenzia Sanitaria e Sociale Regionale Emilia-
Romagna, in collaboration with the CeVEAS-AUSL Modena and the Regional
ProBA Group in Italy used a two-step survey to first investigate
family and hospital pediatricians' knowledge and attitude towards
antibiotics, as well as that of parents', and then to determine the
factors associated with pediatricians' actual practices of antibiotic
prescription. They found that for parents, lack of knowledge was the
most important factor potentially associated with over-prescription.

For the pediatricians questioned, 56% thought that diagnostic
uncertainty was the main cause of antibiotic over-prescription, and
only 20% suggested that parental expectations of a prescription was to
blame. However, in observed practices, parental expectation of a
prescription, as perceived by the doctor, was the second highest
factor significantly associated with actual prescription, with the
most important factor being discharge from the child's ear.

"A wide gap between perceived and real determinants of antibiotic
prescription exists", says lead researcher Maria Luisa Moro, "This can
promote antibiotic overuse." Unnecessary prescription of antibiotics
is dangerous as it increases the prevalence of antibiotic resistant
bacteria. Of the European countries, Italy has particularly high rates
of antibiotic prescription and resistance, therefore reducing
inappropriate antibiotic use in this country is particularly
important. She concludes, "All of the above results confirm the
crucial role of cultural factors as well as social factors in
determining the pattern of antimicrobial prescribing in a region."

More information: Why do paediatricians prescribe antibiotics? Results
of an Italian regional project, Maria Luisa Moro, Massimiliano Marchi,
Carlo Gagliotti, Simona Di Mario, Davide Resi and Progetto Bambini e
Antibiotici Regional Group [ProBA] Group, BMC Pediatrics (in press),

Source: BioMed Central