Published online May 8, 2016. doi: 10.5409/wjcp.v5.i2.198
Peer-review started: July 27, 2015
First decision: September 22, 2015
Revised: December 26, 2015
Accepted: January 21, 2016
Article in press: January 22, 2016
Published online: May 8, 2016
AIM: To determine parental knowledge about acute otitis media (AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting (WW) approach in primary care settings in southern Israel.
METHODS: The study was conducted in 3 primary care clinics and the pediatric emergency room of Soroka University Medical Center. Questionnaires (20 questions on education background, previous AOM experience, knowledge on antimicrobial resistance and attitude vs the WW approach) were filled by 600 parents (150 at each centers) of children < 6 years of age.
RESULTS: Mothers represented 69% of parents; 2% had an education of < 10 school years, 46% had high-school education and 17% had an academic degree. 69% parents reported previous experience with AOM and 56% thought that antibiotics represent the only treatment for AOM. Knowledge on bacterial resistance to antibiotics was reported by 57% of the parents; 86% parents were willing to accept/probably accept the WW approach for their children. Logistic regression analysis revealed a significant association between parental education and knowledge about bacterial resistance to antibiotics and that previous experience with AOM was significantly associated with reluctance to accept the WW approach. More parents with knowledge on bacterial resistance were willing to accept the WW approach compared with parents without such knowledge. No correlation was found between the education level and willingness to accept the WW approach.
CONCLUSION: A significant correlation was found between previous parental education and experience with AOM and the knowledge about antibiotic use, bacterial resistance and acceptance of the WW approach.
Core tip: The 2004 and 2013 guidelines of the American Academy of Pediatrics suggest the use of a watchful waiting (WW) approach to antibiotic therapy in a selected group of children with acute otitis media (AOM). We determined the parental knowledge about AOM and its antibiotic therapy, antibiotic resistance and the willingness to comply with the WW approach in primary care settings and found a significant correlation between parental education level, previous experience with AOM, knowledge about antibiotic use and about bacterial resistance and the acceptance of the WW approach.