Prevalence of inappropriate use behaviors of antibiotics and related factors among parents in eastern China: an online cross-sectional survey

Objective This study aimed to investigate parental knowledge about antibiotic use, estimate the prevalence of inappropriate antibiotic use behaviors, identify related factors among parents in eastern China, and provide targeted suggestions for promoting rational antibiotic use in children. Methods A cross-sectional survey was conducted between October and November 2024. A multistage stratified cluster random sampling method and a self-administered questionnaire were used to collect demographic and sociological characteristics, knowledge, and behaviors regarding antibiotic use from 2,575 parents in eastern China. Logistic regression models were used to analyze the factors influencing the inappropriate use of antibiotics. Results Among the 2,575 participants, 49.05% reported self-storage of antibiotics (SSA) for their children, 21.90% reported self-medication with antibiotics (SMA), 57.13% reported non-adherence to antibiotic treatment (NAAT), and 8.04% reported using antibiotics for disease prevention in their children in the past year. Multivariate logistic regression analyses showed that parents scored less than 5 were more likely to report NAAT (adjusted OR [aOR] = 1.45, 95% CI = 1.15–1.83) and use antibiotics for disease prevention (aOR = 5.62, 95% CI = 3.26–9.69) in their children and less likely to report SSA (aOR = 0.68, 95% CI = 0.54–0.86). Storing antibiotics at home was associated with an increased likelihood of SMA (aOR = 7.25, 95% CI = 5.69–9.24) and using antibiotics for disease prevention in children (aOR = 8.42, 95% CI = 5.61–12.63). Conclusion In Nantong City, eastern China, parents with low levels of antibiotic knowledge demonstrated a high frequency of inappropriate antibiotic use for children. To promote rational antibiotic use, efforts should focus on improving parental knowledge through health education, formulation of rational use strategies, and reducing antibiotic storage at home.