Mixed methods case study exploring primary care antibiotic prescribing practices and maternal attitudes to the use of antibiotics in children

Background. Overuse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance. Most antibiotics in the United Kingdom (71.4%) are prescribed in primary care by general practitioners, with about half prescribed for viral rather than bacterial illnesses. Aims. To explore antibiotic prescribing and factors which may influence maternal decision making to seek antibiotics for their young children. Methods. Data for children under five years was gathered using a mixed methods case study approach. Quantitative general practice antibiotic prescribing data (n= 697 children) was statistically analysed and these results were further explored in six focus groups with mothers (n=19) of children under five. The qualitative data was thematically analysed. Results. Quantitative data identified nearly half of children received antibiotics. Children under one were prescribed the fewest antibiotics. Qualitative focus group data showed mothers trusted their general practitioner to provide expert care for their child and often wanted convenient and timely access to advice and reassurance, rather than treatment. Conclusion. Antibiotics are frequently prescribed for young children in primary care. Healthcare professionals need to understand the maternal influences contributing to antibiotic use in children and consider strategies and interventions to reduce unnecessary antibiotic prescriptions.