上海市某城区家长对儿童使用抗菌药物的知信行调查

Parents′knowledge,attitudes and practice on antibiotics use in children

目的了解家长对儿童使用抗菌药物的知识、态度和行为,以促进抗菌药物在儿童中的合理使用,减少细菌耐药和不良反应在儿童中的发生。方法 2018年1月1日至6月30日在上海市浦东新区塘桥社区卫生服务中心儿童预防保健科对482名家长关于儿童使用抗菌药物的认知、态度和行为状况进行调查,通过logistic回归分析对儿童家长认知和自行使用抗菌药物的相关影响因素。结果在认知方面,89.0%(429/482)的家长认同普通感冒不需要用抗菌药物治疗;88.8%(428/482)的家长知道抗菌药物有不良反应;82.0%(395/482)的家长知道抗菌药物的过度使用会使致病菌产生耐药性的可能增加。相关知识获取途径69.7%(327/482)来自医生。在态度方面,84.1%(405/482)的家长对我国民众存在过度使用抗菌药物的现象表示认同;68.2%(405/482)的家长认同孩子患病应听从医生方案不向医生提要求;30.7%(148/482)的家长认为自己足够了解抗菌药物知识;24.7%(148/482)的家长在孩子患病时愿意使用价格比较贵的抗菌药物。在行为方面,13.9%(67/482)的家长会自行购买抗菌药物;35.7%(172/482)的家长在家里备有抗菌药物。多因素回归分析结果显示,家庭年收入高的家长能够更好地了解抗菌药物(OR=2.619,95%CI:1.431~4.793);家长在家里备有抗菌药物(OR=4.713,95%CI:1.964~11.309),自行购买过抗菌药物(OR=2.768,95%CI:1.237~6.194)都会增加自行给孩子使用抗菌药物的可能性。结论塘桥社区家长对儿童使用抗菌药物的知识、态度和行为存在一定问题。需要进一步普及儿童抗菌药物的宣传教育,以促进抗菌药物在儿童中的合理使用。

Objective To analyze parents'knowledge,attitudes and practice(KAP)on antibiotics use in children.Methods A survey of parents'KAP on antibiotics use in children was conducted among 482 parents in Tangqiao community who were visiting the vaccination unit of our center during January to June 2018.The influencing factors of patients'KAP on antibiotics use in children were investigated with univariater and multivariate logistic regression analysis.Results In terms of knowledge,89.0%(429/482)of parents agreed that common cold did not require antibiotics treatment;88.8%(428/482)of parents knew that antibiotics had adverse reactions;82.0%(395/482)of parents knew that overuse of antibiotics would increase the possibility of drug resistance of pathogenic bacteria;and 69.7%(327/482)of the relevant knowledge acquisition came from doctors.In terms of attitudes,84.1%(405/482)of the parents agreed with the phenomenon of excessive use of antibiotics in our country;68.2%(405/482)of the parents agreed that they should follow the doctor's instruction but not ask the doctor to prescribe drugs;30.7%(148/482)parents thought they had enough knowledge about antibiotics drugs;24.7%(148/482)parents were willing to use more expensive antibiotics for their children.In terms of practice,13.9%(67/482)of parents would buy antibiotics by themselves;35.7%(172/482)of parents had antibiotics at home.Multi-factor regression analysis results showed that parents with high annual family income are likely to better understand antibiotics(OR=2.619,95%CI:1.431—4.793);parents who had antibiotics at home(OR=4.713,95%CI:1.964—11.309)and purchased antibiotics by themselves(OR=2.768,95%CI:1.237—6.194)were more likely to use antibiotics for their children.Conclusion There are still some problems in parents'knowledge,attitude and behavior of using antibiotics in children in the community,and public education on rational use of antibiotics in children is necessary.