Parental health seeking behaviour, knowledge and expectations around ear infection symptoms in children

Background An estimated half a million UK primary care consultations are due to middle ear infections annually. In children, ear infections are one of the most common reasons for antibiotic use. Aim To describe parents’ experiences and actions for their child’s ear infection symptoms. Design & setting Online survey with parents of children aged 10 years or younger who had suspected ear infection symptoms in the previous 12 months in England. Method Data were collected retrospectively and through self-report. Multivariable logistic regression explored association of variables with consulting and reported prescription of antibiotics. Results 503 parents participated. Most parents perceived their child’s symptoms as mild (25.8%) or moderate (64.6%). Consulting healthcare was the most reported action (90%); 74% consulted within 1-2 days. Perceived severity and duration of symptoms were associated with consulting. Parents were concerned about serious illness and the need for treatment. Other factors associated with consulting were missing work (AOR 4.8, 95% CI: 1.6 – 14.8), childcare impacts (AOR 3.1, 95% CI: 1.0 – 9.5) and fluid in child’s ear (AOR 3.9, 95% CI: 1.48 - 10.5). Of consultors (454/503), 55.7% reported receiving an antibiotic. Of all parents (503), 36% believed children always require antibiotics for ear infections. Conclusion Most parents consult for their child’s ear infection symptoms and are prompted by impacts on daily life and perceptions of risk and treatment needs. There are knowledge gaps, which if addressed, may help to reduce primary care consultations and antibiotic use by supporting parents to manage self-limiting ear infections in children.