Antibiotic use in kids: More misconceptions among Medicaid parents

Misconceptions about antibiotic use persist and continue to be more prevalent among parents of Medicaid-insured children, according to a study published in Pediatrics.

Dr Vaz“Misunderstandings about the appropriate use of antibiotics for childhood infections remain common among parents with children under the age of 6,” according to lead author, Louise Vaz, MD, MPH, assistant professor, pediatric infectious diseases, medical director, Outpatient Antibiotic Therapy Program, Oregon Health & Science University.

In spring 2013, Dr Vaz and colleagues surveyed a total of 1,500 Massachusetts parents with a child aged 6 years old and younger insured by a Medicaid managed care or commercial health plan. The researchers examined antibiotic-related knowledge and attitudes in 2013 and also compared them to a similar survey conducted in 2013.  Multivariable modeling was used to assess current sociodemographic predictors of knowledge and evaluate changes in predictors from a similar survey in 2000.

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 “While Medicaid parents showcase a higher rate of antibiotic misconception, the data indicate there is room to improve understanding of appropriate treatments for common illnesses regardless of insurance group,” she said.  “When we analyzed data over a 13-year period [2000 to 2013], we found that relatively little progress has been made in correcting key misconceptions.”

For example, more than half of Medicaid parents surveyed in 2013 still thought antibiotics were necessary for the treatment of colds and the flu, versus 20% of the commercially insured group (similar to 2000). Further, 50% of commercially insured parents and more than 60% of 2013 Medicaid families believed cases of green nasal discharge would require antibiotics. Even more surprising, 85% from both insurance groups felt antibiotics were vital to effective bronchitis treatment.

“These findings are important as parental attitudes may influence pediatricians to prescribe antibiotics when they may not be necessary, contributing to overuse of antibiotics,” Dr Vaz said.

NEXT: 3 important antibiotic take-aways

Dr Vaz believes that healthcare needs to better tailor its messages to “the specific misconceptions out there, particularly for colds, flu and bronchitis. The modalities for how this can or should be done will need to be explored. With various stakeholders involved, be it parents, physicians, insurance companies, and public health, it will likely take a coordinated effort to accomplish.  There may not be a one-size-fits-all model.”

Related:The 5 most over-prescribed antibiotics

It is necessary that providers understand that misconceptions among their patients continue to exist, she continued. “Time spent explaining the rationale behind prescribing or not prescribing antibiotics could serve as educational and improve satisfaction for families eager to make their child well.  Our research indicates that parents still hold the majority of their medical trust in their primary care provider. Given this, we believe that any interventions, whether conducted within health systems or public health, needs to be done in partnership with providers.”   

Related: Top 5 ways bacteria are becoming resistant to antibiotics

Dr Vaz shared 3 important antibiotic take-aways: 

• Antibiotics are only effective against a bacterial infection such as urinary tract infection, strep throat, pneumonia or ear infection. Viruses, such as colds and the flu will not be remedied via antibiotics.

• Antibiotic overuse can lead to drug resistance, and limiting antibiotics to treat bacterial infections is important. 

• Understanding when antibiotics can and should be used should be collaborative effort among families and their providers.