title: Differences in antibiotic use and knowledge between adolescent and adult mothers in Ecuador.
abstract: OBJECTIVE
  To investigate the differences in antibiotic use and knowledge between adolescent and adult mothers of children under the age of 5 years in Ecuador.
  
  
  METHODS
  A cross sectional study was performed in four health centers and hospitals. Mothers of children under five years, seeking medical attention their child's upper respiratory tract infection (URI), were included. The data was collected through interviews, using a structured questionnaire. The questionnaire covered the topics knowledge of antibiotic treatment, risk and resistance.
  
  
  RESULTS
  777 mothers were included in the study, of which 15.8% were adolescent and 84.1% adult mothers. There were significant differences in the social and economic characteristics of the mothers (p ≤ 0.05), with adolescent mothers being more likely to have an incomplete high school education and lack of basic services in their home. Significant differences between these groups were found in adherence to treatment, knowledge about risks associated with antibiotic use, and having heard of antibiotic resistance. Among the adult mothers, 83.5% reported correct adherence, 28.5% were knowledgeable about risks associated with antibiotic use, and 29.3% had heard of antibiotic resistance. Among the adolescent mothers, these numbers were 75.4%, 15.0%, and 19.8%, respectively.
  
  
  CONCLUSIONS
  To develop successful interventions, it is crucial to understand the factors causing differences in antibiotic use and knowledge between mothers.
authors.affiliation: International Center for Health Systems Research and Education, Radboud University Nijmegen Medical Centre, 500 HB, Nijmegen, Netherlands ; Faculty of Medical Sciences, University of Cuenca, Cuenca, EC010107, Ecuador.
authors.forename: Arturo
authors.initials: A
authors.lastname: Quizhpe P
authors.affiliation: Radboud University Nijmegen Medical Centre, 6500 HB, Nijmegen, Netherlands.
authors.forename: Martyna
authors.initials: M
authors.lastname: Gassowski
authors.affiliation: Department of Internal Medicine, University of Cuenca, Cuenca, EC010107, Ecuador.
authors.forename: Lorena
authors.initials: L
authors.lastname: Encalada T
authors.affiliation: Department of Primary and Community Healthcare, Radbound University Nijmegen Medical Centre, 6500 HB, Nijmegen, Netherlands.
authors.forename: Francoise
authors.initials: F
authors.lastname: Barten