Briana D's Policy paper

Policy on Parental Education

Antibiotic resistant bacterium is one of the most threatening health problems facing the world today. Common illnesses are becoming untreatable by current antibiotics. This can cause longer hospital stays, more expensive and toxic medicine, and even death. One major cause of antibiotic resistance is that antibiotics are being prescribed for viruses, even though they are only effective in treating illnesses caused by bacteria (2008 CDC). In 1992 over 20% of all antibiotic prescriptions given for children were for viruses such as colds, upper respiratory infections, and bronchitis. Studies have also shown that antibiotics are prescribed for colds in 44% of visits and 46% of the time for upper respiratory infections (2002 Perz et al.). One specific study of children during a three week period found that 92% of the prescriptions given in five family practices were for acute respiratory infections (2005 Haung et al.). Lack of patient knowledge about antibiotics and antibiotic resistance is one reason over prescribing is occurring.
When participants in a recent study were asked if they believed antibiotics would help them get better more quickly from a cold 28% answered yes. Also a lack or understanding about antibiotic resistance was shown in the study. Of the respondents 58% did know that health dangers such as antibiotic resistance are associated with taking antibiotics (2003 Eng et al.). It is very important that parents in particular learn about proper use of antibiotics.
Children present such concern because they are prescribed the most antibiotics and have the highest rate of infection. By the 1990’s an average of one oral antibiotic prescription per year was given to children under 15 for treatment of respiratory infections (2002 Perz et al.). One study of parents found that 47.6% of respondents answered that they expect a prescription for antibiotics when they go to the doctor with a cold (2003 Eng et al.). When parent do not have knowledge they will often pressure physicians to write prescriptions. This causes the number of unnecessary antibiotic used among children to be so high.
The Boston University School of Medicine conducted a study to try and understand how parents can manipulate the prescribing patterns of physicians. It found several interesting pieces of information. 40% of the physicians surveyed said that at least 10 times or more in the last month a parent had asked for a prescription which was not necessary. Also, it found that 48% of the time parents pressure the physician to prescribe an unneeded antibiotic and 1/3 of the physicians said that they frequently comply with these requests. Over half of the physicians said that parental pressure influenced them most. Many physicians believe that the most efficient program to reduce inappropriate oral antibiotic use would be through parental education (1999 Bauchner et al.). This policy will allow for parental education on antibiotics and antibiotic resistance.


A. Mercy Hospital in Sioux City Iowa will initiate a parental education program on antibiotics. This program will target parents of young children and teach them the difference between illnesses that can and cannot be effectively treated with antibiotics. It will also teach educate parents of the threat that antibiotic resistance poses.
B. Before being dismissed from the hospital after delivery of a child, all new parents will be educated. A nurse will sit with them and explain which illnesses can and cannot be treated by antibiotics. The parents will be told that antibiotics cannot treat or help illnesses such as colds and upper respiratory infections. Along with this information the nurse will inform new parents of the danger that antibiotic resistance poses. Parents will be educated that unnecessary use of antibiotics could endanger their child in the future if they do get a bacterial infection. The nurse will also answer any questions the new parents may have and clear up any misconceptions.
C. Lastly the nurse will give the parents a packet with the detailed information about antibiotics. This packet will include a website and phone number for additional information on antibiotic resistant bacteria prevention.

An argument could be made that antibiotic educational programs for parents are not effective. It has been shown in many studies in the past that this is not the case. The Knox County Health Department implemented an antibiotic educational program and found that antibiotic prescription rates declined 19%. This is a large percentage that shows the effectiveness of educational programs (Perz et al. 2002).
A second possible argument is that physicians are not influenced by parental pressure. A study showed that half of the physicians polled indicated that parental pressure influenced them more then other factors. This information shows that physicians are heavily influenced by parental pressure, disproving the posed argument (1999 Bauchner et al.).

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