title: Parental knowledge of antibiotic use in children with respiratory infections: a systematic review.
abstract: OBJECTIVE
  Antimicrobial resistance (AMR) is an increasing global problem. AMR threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. The misuse and overuse of antibiotics (AB) is the major contributor to the emergence of resistant bacteria in humans. To present and describe characteristics in parents' knowledge about when and how to use AB for an upper respiratory tract infection (URTI), their attitudes towards doctors and AB use in general, and their behaviour when their child suffers from an URTI.
  
  
  RESULTS
  The database search was conducted in EMBASE and PubMed for articles published in English, French, Spanish and Scandinavian languages from the inception until May 2016. Qualitative and quantitative studies with focus on parent' knowledge, attitude and behaviour concerning treatment with AB for URTIs among children and adolescents were included. Extracted information included date of study, design, focus, location and population, parental knowledge, attitudes and behaviours regarding paediatric AB use and parental socioeconomic and sociodemographic characteristics. Parental knowledge about the causes of URTIs and when to use AB, education and parental and children's age affect attitudes and behaviours. However, good level of knowledge about AB (when and how to use it), often correlated with living in a Western country and belonging to high socioeconomic position, does not always imply judicious use of AB for URTIs among children. Providing parents with a contingency plan and clarifications on why an AB is not needed for common colds improves parental satisfaction with their physicians.
  
  
  CONCLUSIONS
  Evidence gathered from 20 countries from studies published in the last 20 years shows that parental knowledge still plays a major role in when and how to use AB for URTIs among children. However, parents are not disappointed if the physician does not prescribe AB, provided that proper explanations and a contingency plan are given.
authors.affiliation: Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Cantarero-Arévalo
authors.affiliation: Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mia Pavelics
authors.initials: MP
authors.lastname: Hallas
authors.affiliation: Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Susanne
authors.initials: S
authors.lastname: Kaae
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D010290:Parents / Q000523:psychology*; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibacterial agents; Antibiotics; Children; Parental knowledge; Respiratory Infections; systematic review