Dissonant views: comparing GPs’ and parents’ perspectives on common colds and antibiotic prescribing for young children

Problem

Antibiotics are not recommended for treating common respiratory tract infections (RTIs) in children. However, studies from the UK, US, and Australia indicate that antibiotic prescribing for young children is widespread in primary care. General practitioners (GPs) may wish to reduce antibiotic prescribing, but they report parental pressure to prescribe and fear of losing patients if they did not receive antibiotics as key barriers. The aim of this study was to compare and contrast GPs’ and parents’ perceptions regarding antibiotic prescribing for managing RTIs in young children in Australia.

Approach

A mixed methods approach was used comprising semi-structured interviews with 20 GPs and a questionnaire survey and focus groups with 50 parents regarding their views and knowledge of antibiotic prescribing for RTIs in young children. Data were collected in Melbourne, Australia, between June 2014 and July 2015. Data from interviews and focus groups were thematically analysed in NVivo and data from the survey were analysed using SPSS.

Findings

GPs believed that parents expected to receive antibiotics for their child’s illness prior to attending the consultation. They commented that they were more likely to succumb to parental pressure to prescribe antibiotics if parents were insistent and also expressed concern that parents would go elsewhere if they did not prescribe antibiotics. GPs also thought that there would be less potential for conflict during the consultation if parents were better educated on appropriate antibiotics use.In contrast, parents demonstrated good knowledge of common colds and the appropriate use of antibiotics. Their main expectation from the GP visit was to obtain a diagnosis for their sick child, discuss management options with the GP, and receive reassurance that the illness was not serious. Parents stated that their satisfaction with the GP visit was not dependent on receiving antibiotics (r = 0.658, p<0.001), and that they would not seek another GP if antibiotics were not prescribed (r = 0.655, p<0.001).

Consequences

Dissonant views on antibiotic prescribing for common colds for young children were found between GPs and parents. GPs need to be reassured that parents do not necessarily want antibiotics for their child and that satisfaction of the visit is not related to receipt of an antibiotic prescription. Targeted training for both GPs and parents may improve communication, which may further reduce unnecessary antibiotic prescribing.