Antibiotic resistance: is knowledge the only driver for awareness and appropriate use of antibiotics?

Background: The fight against antibiotic resistance (AR) is nowadays a world priority. Antibiotic resistance is largely associated with the overuse of antibiotics and a lack of awareness of the problem. Considering the large use of antibiotics in the paediatric age, the aim of this study was to investigate the knowledge and perception of antibiotic resistance in a sample of parents. Methods: A cross-sectional study was conducted on a sample of parents of children aged 0-14. Data on antibiotic use and awareness of antibiotic resistance were collected by a self-administrated questionnaire. The potential predictors of the antibiotic resistance awareness were evaluated using a multivariate logistic regression model. Results: The questionnaire was completed by 610 parents of which 91% (n=553) used antibiotics for their children. Summarizing the answers related to antibiotic resistance knowledge and perception, 36% of parents gave a correct answers to at least 9 of 12 questions. Fever seemed to represent a reason of anxiety in parents. Using a 10-point scale, the perceived anxiety by parents was measured based on a situation when the child wakes up in the morning with a fever at 38°C and the doctor suggests to wait at least 48 hours before administering the antibiotic. Almost half of parents (49%) indicated a low degree of anxiety (1-4), 31% medium (5-6), and 20% high (7-10). Multivariate analysis showed that a good level of education, healthcare occupation and low grade of anxiety are associated with antibiotic resistance awareness. Conclusions: The awareness of antibiotic resistance is not strong. The study highlights the need to put effort on tailored education programs aimed to improve knowledge of antibiotic resistance and guide mainly anxious parents to appropriate management of disease of their children.