Upper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of
viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The
problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and
middle-income developing countries.
Our study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April
2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general
pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.
554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any
child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of
parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents
stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9%
of them declared that they never used past antibiotics in the presence of a new infection. Female gender,
high level of education, high income level and low number of antibiotics used in the last 1 year were
found to be statistically signicant with the better knowledge level of the parents (p <0.05).
According to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though
generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the
National Action Plan are partially working. However, it is still necessary to continue to inform parents,
pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the
prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent
unnecessary antibiotic prescriptions.
Upper respiratory tract infections (URTIs) are common in children. This is probably due to the vulnerability
of children to URTIs [1, 2 ] However, most URTIs have been shown to be of viral origin. In this case, the use
of antibiotics is unnecessary and not suitable .
The World Health Organization (WHO) reported in its report published in April 2014 that antibiotic
resistance was a serious and growing global problem . Inappropriate antibiotic use is one of the main
causes of antibiotic resistance [5, 6]. The problem of unnecessary antibiotic use among children is a
concern for antibiotic resistance in low- and middle-income developing countries [5, 7].
There are many reasons for inappropriate antibiotic use in children. In some cases, it may be due to the
fact that families have an infection that should have used antibiotics before, and then, when a similar
viral infection develops, it will not be cured without antibiotics . In addition, antibiotics are started even
in cases where the infection is thought to be viral due to the poor geographical conditions of the area
where the physician works, lack of equipment, the fear that the patient will not be able to reach the
physician easily or the sick child will not be brought to control [9, 10]. Furthermore, the indifference of
parents in pediatric patients and the pressure to prescribe antibiotics on pediatrician also lead to
inappropriate antibiotic use. As a result, the administration of antibiotics provides minimal benet, even
harm (side effects, resistance, etc.) [11, 12]
Many studies have reported the relationship between antibiotic use and the development of resistance
[13–15]. Turkey is one of the world's countries with the highest consumption of antibiotics is located in
European regions outside the European Union . The latest report from the Organisation for Economic
Co-operation and Development (OECD) Health Policy Studies, in 2015, the highest rates of antimicrobial
resistance (Turkey, Korea and Greece in about 35%) of the lowest rates among the member countries
stated that seven times higher .
Turkey has two main antimicrobial stewardship program created by the Ministry of Health. The rst
targets the hospitals, the second the society. The antimicrobial stewardship program targeting the
community includes a 4-year (2014–2017) National Action Plan for Rational Drug Use, with an emphasis
on antimicrobials at the community level. The aim is to reduce antimicrobial prescriptions, especially
prescriptions for acute respiratory infections, in primary care. In this plan, it is aimed to inform doctors,
pharmacists and the public on rational drug use. The sale of antibiotics without a prescription is
prohibited in pharmacies. Antibiotics can only be prescribed by the doctor. However, various studies are
needed to determine whether the National Action Plan is effective or not. Among these, the knowledge,
attitudes and behaviors of parents about the use of antibiotics are of great importance. There are limited
studies on this subject in Turkey and is made in a limited participant [18, 19].
In this study, a tertiary care hospital in Turkey, the parents of URTIs with antibiotic treatment knowledge,
their attitudes regarding the use, communication with pediatricians for medical treatment and practices
of administering antibiotics to their children.