Antibiotici u pedijatriji - stavovi i znanja roditelja
Sažetak
Uvod: Antibiotici predstavljaju najpropisivaniju klasu lekova u pedijatrijskoj populaciji. Skoro 50% antibiotika izdatih na nivou primarne zdravstvene zaštite nije bilo propisano na osnovu nacionalnih preporuka za lečenje. Rezultati nedavno završenih istraživanja ukazuju da stepen znanja i informisanosti, kao i očekivanja roditelja imaju veliki uticaj na potrošnju antibiotika u pedijatrijskoj populaciji.
Cilj: Proceniti nivo znanja, stavove i postupke roditelja u Srbiji vezane za upotrebu antibiotika u lečenju dece.
Materijal i metode: Studija preseka je sprovedena u periodu od oktobra 2015. do februara 2016. godine na teritoriji Srbije. Korišćen je anonimni upitnik kojim su obuhvaćeni podaci o demografskim karakteristikama, kao i znanje i stavovi roditelja prema upotrebi antibiotika u dečijem uzrastu. Podaci su analizirani metodama deskriptivne i analitičke statistike.
Rezultati: Od ukupnog broja ispitanika uključenih u istraživanje, 90% je popunilo i vratilo evaluacioni upitnik (850/763). Visok nivo znanja roditelja o primeni antibiotika kod dece je primećen u 79,5% slučajeva. Najveći procenat roditelja je tačno odgovorio na pitanja o potrebi prijave neželjenih reakcija kao i o mogućnosti nastanka alergijskih reakcija na antibiotike (99% i 93%). Skoro trećina ispitanika (27%) je mislilo da antibiotici leče virusne infekcije. Petina roditelja je smatrala da antibiotici otklanjaju bol kod dece, kao i da su skuplji antibiotici efikasniji. Zabrinjavajuća je činjenica da je 15% roditelja makar jednom kupilo antibiotik bez recepta, kao i da 18% njih zadržava ostatke neupotrebljenih lekova.
Zaključak: Uprkos visokom stepenu znanja koji su roditelji pokazali o upotrebi antibiotika, manji procenat roditelja je sklon samoinicijativnom donošenju odluka o započinjanju i sprovođenju antibiotske terapije. Iz ovog razloga postoji potreba za unapređenjem edukativnih programa i poboljšanjem komunikacije sa izabranim pedijatrima.
Ključne reči: antibiotici, znanje, stavovi, roditelji, deca.
Reference
McLellan NJ, Gray J. The rational use of antibiotics in bacterial infection. Curr Pediatr. 2001 Dec; 11(6):438-444.
Nordlie AL, Andersen BM. Parents' attitudes to the prescription of antibiotics to children. Tidsskr Nor Laegeforen. 2004 Sep 9; 124(17):2229-31.
Clavenna A, Bonati M. Differences in antibiotic prescribing in paediatric outpatients. Arch Dis Child. 2011 Jun; 96(6):590-5.
Hersh AL, Jackson MA, Hicks LA. Principles of judicious antibiotic prescribing for bacterial upper respiratory tract infections in pediatrics. Pediatrics. 2013 Dec; 132(6):1146-1154.
Ferech M, Coenen S, Malhotra-Kumar S, et al. European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe. J Antimicrob Chemother. 2006 Aug; 58(2):401–7.
Božić B, Bajčetić M. Use of antibiotics in paediatric primary care settings in Serbia. Arch Dis Child. 2015 Oct; 100(10):966-9.
Alili-Idrizi E, Dauti M, Malaj L. Validation of the parental knowledge and attitude towards antibiotic usage and resistance among children in Tetovo, the Republic of Macedonia. Pharm Pract (Granada). 2014 Oct; 12(4):467.
Yu M, Zhao G, Stalsby Lundborg C, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis. 2014 Feb 27; 14:112.
Zyoud SH, Abu Taha AA, Araj KF, et al. Parental knowledge, attitudes and practices regarding antibiotic use for acute upper respiratory tract infections in children: a cross-sectional study in Palestine. BMC Pediatr. 2015 Nov 11; 15:76.
NICE Short Clinical Guidelines Technical Team Respiratory tract infections–antibiotics prescribing. Prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care. London, National Institute for Health and Clinical Excellence. 2008.
Guven GS, Uzun O. Principles of good use of antibiotics in hospitals. J Hosp Infect. 2003 Feb; 53(2):91–6.
Spellberg B, Guidos R, Gilbert D, et al. The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. Infectious Diseases Society of America. Clin Infect Dis. 2008 Jan 15; 46(2):155-64.
Ling Oh A, Hassali MA, Al-Haddad MS, Syed Sulaiman SA, Shafie AA, Awaisu A. Public knowledge and attitudes towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia. J Infect Dev Ctries. 2011 May 28; 5(5):338-347.
Rousounidis A, Papaevangelou V, Hadjipanayis A, et al. Descriptive Study on Parents’ Knowledge, Attitudes and Practices on Antibiotic Use and Misuse in Children with Upper Respiratory Tract Infections in Cyprus. Int J Environ Res Public Health. 2011 Aug; 8:3246-3262.
Al-Dossari K. Parental knowledge, attitude and practice on antibiotic use for upper respiratory tract infections in children. Majmaah J Health Sciences. 2013; 1(1):39-51.
Suda KJ, Hicks LA, Roberts RM, Hunkler RJ, Taylor TH. Trends and seasonal variations in outpatient antibiotic prescription rates in the United States, 2006 to 2010. Antimicrob Agents Chemother. 2014 May; 58(5):2763-6.
Mitsi G, Jelastopulu E, Basiaris H, Skoutelis A, Gogos C. Patterns of antibiotic use among adults and parents in the community: A questionnaire-based survey in a Greek urban population. Int J Antimicrob Agents. 2005 May; 25(5):439-443.
Shehadeh M, Suaifan G, Darwish RM, Wazaify M, Zaru L, Alja'fari S. Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi Pharm J. 2012 Apr; 20(2):125-133.
Eglė P, Vincentas V, Asta M, Vytautas M, Kęstutis P, Edgaras S. Public Knowledge, Beliefs and Behavior on Antibiotic Use and Self-Medication in Lithuania. Int J Environ Res Public Health. 2015 Jun; 12(6): 7002–7016.
Francesco N, Maria TI, Gabriella DG, Italo FA. Public Knowledge, Attitudes, and Experience Regarding the Use of Antibiotics in Italy. PLoS One. 2013 Dec 13; 8(12): e84177.
Muras M, Krajewski J, Nocun M, Godycki-Cwirko M. A survey of patient behaviours and beliefs regarding antibiotic self-medication for respiratory tract infections in Poland. Arch Med Sci. 2013 Oct 31; 9(5):854-7.
Stručno-metodološko uputstvo za sprovođenje uredbe o nacionalnom programu zdravstvene zaštite žena, dece i omladine. Institut za zdravstvenu zastitu majke i deteta Srbije- dr Vukan Čupić. http://www.imd.org.rs/files/strucno-metodolosko-uputstvo.pdf (preuzeto 12.11.2016)