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Practice of parents and pharmacists regarding antibiotics use in pediatrics: A 2017 cross-sectional study in Lebanese community pharmacies.

OBJECTIVES
To assess practices of community pharmacists towards prescribing or dispensing antibiotics without prescription to children, determine obstacles that stand in the way of best practices, and determine whether parents misuse antibiotics when administering them to their children.


METHODS
A cross-sectional study, conducted between June 2017 and August 2017 on a random sample of community pharmacies, enrolled 202 community pharmacists and 204 parents.


RESULTS
A total of 84.6% of pharmacists prescribed antibiotics for children in community pharmacies, particularly for the treatment of pharyngitis (67.5%), otitis media (56%), or diarrhea/vomiting (40.4%); 54.2% of these pharmacists reported prescribing antibiotics to children under 2 years of age, while 14.4% reported only prescribing antibiotics for children aged six and above. Most pharmacists cited pressure from the child's parents as a reason for prescribing antibiotics, while parents not being able to afford the doctor's visit was cited by 24.7%. When dispensing antibiotics for use by children, 23.5% of the pharmacists reported recommending a small or large spoon two to three times daily, regardless of the standard dose or the child's weight. In addition, 21.7% of the pharmacists reported always dispensing the entire bottle of antibiotics, while 5.4% do not specify the treatment's duration. From the parents' side, 38% reported that the most recent purchase of an antibiotic for their child was made without a medical prescription, while 20.6% reported that they did not follow medical instructions regarding treatment's dosage and duration; 64.3% reported ending the antibiotic treatment early if their child felt better. Most of the parents reported diluting the antibiotic incorrectly, with half of them not shaking the bottle well enough before adding in water.


CONCLUSION
These study results demonstrated poor practices of community pharmacists towards dispensing antibiotics without a prescription, and in parents when administering them to their children. Educational campaigns to increase awareness on antibiotics misuse in pediatrics are warranted.