Child/Adolescent Health

Medicaid-insured parents could benefit from educational programs to promote more judicious use of antibiotics

Inappropriate use of antibiotics contributes to the growing problem of antibiotic-resistant infections. Yet some parents pressure doctors into prescribing antibiotics for children when they don't need it, for example, for viral infections that cannot be treated with antibiotics. Knowledge about appropriate use of antibiotics seems to be improving, but appears to be doing so more quickly among more socially advantaged populations. Parents of Medicaid-insured children may need more educational interventions to improve judicious antibiotic use, according to a new study.

Researchers conducted a 3-year, multicommunity educational intervention directed at parents of children under 6 years of age in 16 Massachusetts communities (8 intervention and 8 control communities). Parents in the eight intervention communities were mailed educational newsletters and exposed to educational materials during visits to local pediatric providers, pharmacies, and child care centers.

The researchers compared responses from mailed parent surveys in 2000 (before the intervention) with those in 2003 (after the intervention) for both intervention and control communities. Parental knowledge about antibiotics improved with time in both intervention and control communities.

The educational campaign in intervention communities did not improve overall community-level parental knowledge about antibiotics beyond the general secular trend, except for the parents of Medicaid-insured children, whose knowledge increased as a result of the campaign. Also, there was evidence of a smaller secular trend of increased knowledge among this group compared with more socioeconomically advantaged groups. These two findings may indicate limited access of parents of Medicaid-insured children to health-related information from other sources.

For example, the direct-to-consumer mailing in this study might have provided some Medicaid families with their first exposure to information related to the proper indications for antibiotics, as well as clarification of common parental misconceptions. In contrast, other more advantaged families might have received these messages through other channels.

The study was supported by the Agency for Healthcare Research and Quality (HS10247).

More details are in "Parental knowledge about antibiotic use: Results of a cluster-randomized, multicommunity intervention," by Susan S. Huang, M.D., M.P.H., Sheryl L. Rifas-Shiman, M.P.H., Ken Kleinman, Sc.D., and others, in the April 2007 Pediatrics 119, pp. 698-706.

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