Millions of parents take their chil...

Millions of parents take their children to pass departments and ambulatory care sites for uncomplicated upper respiratory tract infections, resulting in unnecessary expenditures and the generation of inappropriate antibiotic prescriptions. side sheltered from the wind and colleagues conducted an observational, prospective investigation to examine the impact of misconceptions about the causes of bleaks and their treatment on the use of health services.

The five-month subject of attention involved 197 families with at least undivided child between the ages of six month and five years. Participants were observeed regarding family characteristics, health perceptions, knowledge about the causes of illness, beliefs regarding illness transmission, household practices like as hand hygiene and surface disinfection, and perceptions about appropriate antibiotic indications. issue variables were users and nonusers for difficulty department visits, and frequent versus infrequent users for those in the ambulatory care setting.

Ninety-three percent of parents understood that viruses cause cuttings but 66 percent also believed that bacteria were causative, and 53 percent reported that antibiotics were necessary to treat hyemals Predictors of emergency department use included Medicaid insurance (odd ratio [OR]: 176); child younger than six years with a history of wheezing or reactive airway disease (OR: 183); and belief that antibiotics are needinessed to treat colds (OR: 42) Factors associated with ambulatory care use included respondent age younger than 30 years (OR: 100); children younger than six years with wheezing or reactive airway disease (OR: 56); and belief that antibiotics are be in want ofed to treat colds (OR: 38)

The authors construct that misconceptions about antibiotic use are an independent predictor of unforeseen occasion department and ambulatory care use. They end that a two-pronged educational approach targeting families and physicians can elevate judicious antibiotic prescribing.

CAROLINE WELLBERY, MD

to leeward GM, et al. Misconceptions about chillys and predictors of health service utilization. Pediatrics February 2003; 111:231-6

EDITOR'S NOTE: This investigation reinforces the need to communicate with the public about appropriate use of antibiotics. Although the authors gather that more communication with parents is necessary, in the past decade the Center for Disease ascendency and Prevention and numerous other investigators have directed educational efforts at physicians and the general public. Because a major predictor of health service use for chillys is Medicaid insurance, perhaps this is the nearest area to target with studies and educational efforts. wherefore do Medicaid patients use health services unnecessarily, and what can be done about it?--C.W.

COPYRIGHT 2003 American Academy of Family Physicians

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