Background
Antibiotics are vital in treating infections and improving health conditions. However, overuse has led to the rapid development of antimicrobial resistance contributing to about 700,000 deaths globally per year. In United Kingdom primary healthcare settings, antibiotics for young children are prescribed in up to 50% of all consultations, often for viral infections for which antibiotics are ineffective. As mothers are usually the primary carers of their children, their attitudes and expectations to using antibiotics have a profound influence on their behaviour and the decisions they make on behalf of their children. Any reduction in antibiotic consumption in young children will decrease the risk of antibiotic resistance developing; this remains a significant and real threat to healthcare. The aim of this study is to understand maternal attitudes to antibiotic use in children.
Method
A mixed methods case study design was selected consisting of a quantitative and qualitative phase. In phase one, primary care antibiotic prescribing data was collected for children under five years old between July 2016 and July 2017. The results from phase one were used to explore and inform the second, qualitative phase of the study. This phase involved the recruitment of mothers of children under five years old, from local playgroups. Mothers’ narratives were gathered from six focus groups of between two and five mothers per group, as well as from 14 one to one interviews undertaken between October 2017 and April 2018.
Results
The key findings of the research suggested mothers trust and rely on antibiotics, which are powerful symbols of safety and recovery from illness. However, maternal decision making regarding antibiotics usage is complex, with many variables including the influence of maternal emotions, previous experience, the relationship with their healthcare professional and ultimately their belief and trust in antibiotics. Continuity in healthcare services is important to mothers and supports them in managing their children’s illness. Austerity measures have resulted in a decrease in health visitor access and has led to mothers seeking alternative services for providing support and advice.
Conclusion
Understanding maternal attitudes to antibiotics for young children is vitally important in reducing inappropriate antibiotic prescription. Antibiotics represent recovery and healing and this trust in antibiotics influences maternal expectations of treatment and interactions with healthcare services. However, to address inappropriate antibiotic prescribing in children, more robust national and local data collection is needed. By understanding the extent of antibiotic prescribing in young children, healthcare professionals will be more able to support mothers in their healthcare decisions.
