Parental lack of antibiotic knowledge imperils child health in Bangladesh: Study

A significant number of parents in Bangladesh lack the essential understanding to identify basic antibiotic medications and administer them to their children even for common ailments like fever or sore throat, according to the findings of a recent study. 

The study found that 63% of parents were unaware that amoxicillin is an antibiotic, while about 56% lacked awareness regarding azithromycin. Around 79% correctly identified paracetamol as not being an antibiotic. 

It also revealed that 75% of parents were aware that the misuse of antibiotics could lead to antibiotic resistance. However, 47% believed that antibiotic-resistant bacteria are challenging to treat. 

The study, "Factors contributing to antibiotic misuse among parents of school-going children in Dhaka City, Bangladesh," was published in the prominent scientific journal Nature on 28 January. 

The research spanned the period between August and September 2022, encompassing 704 parents of school-going children in Dhaka South. Over half of the participating parents (58%) had higher secondary education. 

It was conducted by the Center for Health Innovation, Research, Action, and Learning-Bangladesh (CHIRAL Bangladesh). 

Md Jubayer Hossain, lead researcher at CHIRAL Bangladesh, told The Business Standard, "In our research we found parents obtaining prescriptions from social media and administering antibiotics for their children's fevers, often discontinuing the medication before completing the full course." 

He said the research focused on educated parents in urban areas. "The situation in rural villages is even more concerning." 

In addition to governmental efforts, the media and public must also actively combat antibiotic misuse, he said. Community pharmacists should receive training, and community awareness initiatives should be intensified. 

According to the World Health Organization, antibiotic resistance leads to increased mortality, longer hospital stays, and higher medical costs. 

Resistance to antibiotics is common and often deadly among children with pneumonia in Bangladesh, according to a study by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b).

64% misused antibiotics 

The study further revealed that 45% of parents had moderate knowledge, 53% had uncertain attitudes, and 64% misused antibiotics. 

Moreover, over 80% had a positive attitude toward non-antibiotic prescriptions and were satisfied with their doctors' prescriptions. Conversely, 75% disagreed with giving antibiotics to their children without a clear need.

Furthermore, 63% of parents believed antibiotics could treat fever and colds. Additionally, 26% were willing to stop giving antibiotics to their children once they improved, and 27% reused the same antibiotics for similar symptoms.

Around 58% of parents administered antibiotics to their children without consulting a doctor, and 36% preferred obtaining antibiotics from pharmacies instead of doctors. 

Besides, 24% admitted to not checking the expiration date of antibiotics before administering them to their children. 

The study found that the majority of parents relied on information from healthcare providers (86%), with fewer seeking information from pharmacists (36%) and the internet (30%), social media (23%), pharmaceutical companies (11%), or other sources (23%), such as colleagues, nurses, and university courses.

Risk and solution 

Dr Sayedur Rahman, vice-chairman of the Bangladesh Chapter of the Global Antibiotic Resistance Partnership, said the situation of antibiotic resistance is deteriorating. 

"While it may be too late to completely halt its progression, a combination of various interventions can help mitigate further damage," he added. 

Dr Jahidul Islam, associate professor at Bangabandhu Sheikh Mujib Medical University, told TBS that in countries like Malaysia and Singapore, sales of antibiotics are heavily restricted with the government keeping records. 

"Implementing such measures can significantly reduce antibiotic misuse in Bangladesh too. Besides, antibiotic use in agriculture and fisheries should be halted, and public awareness campaigns are essential," he added.