Managing parental expectations for children’s antibiotics

‘When a child is sick it’s a worrying time for parents, but it’s important to remember that antibiotics are not the answer to all infections,’ Dr Andrew Boyden, NPS MedicineWise Medical Adviser, said.
 
The study undertaken by NPS MedcineWise found that such treatment is usually unnecessary and fuels the development of antibiotic resistance.

‘If the child were to contract a serious bacterial infection antibiotics may not work for them in the future, which could be potentially life-threatening,’ Dr Boyden said.
 
However, it can be difficult for GPs to clearly explain this paradigm to worried parents during the course of a normal consultation.

Dr Justin Coleman, a GP with an interest in public health, told newsGP that personalising the issue instead of quoting facts and figures can be an effective way to communicate the message.
 
‘One of the difficulties with over-emphasising antibiotic resistance is that it’s a herd immunity argument, and the parent may think you’re making a decision based on population level, rather than their special child,’ he said. ‘You have to make it clear that you have the wellbeing of their child uppermost in your decisions.’
  
Dr Coleman believes the often long-standing nature of the GP–patient relationship makes general practice the perfect place for the discussion about antibiotic use.
 
‘Although there are challenges with that, general practice has a better chance of getting through because we offer that longitudinal, family-based care. I think that gives us an advantage over a once-off care situation,’ he said.
 
‘Allow yourself time to go back to the basics, take a good history, including a history of how worried the parents are, and examine the child properly. Through the history and the examination, you’re preparing the groundwork for the explanation that’s to follow.
 
‘Once you’re happy that the child doesn’t need an antibiotic, you move into that phase of explanation for the parent.’
 
Dr Coleman acknowledged that this approach takes time, but he believes it is worth the effort and will pay off later.
 
‘Certainly the first one or two times with a regular parent, it takes longer and it takes more of your skills,’ he said. ‘But I think over time it becomes easier, because the parents who come back to you will trust you.’

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