The Factors that Influence Unconvinced Mothers Regarding the Fact that Children were not Prescribed Antibiotics:

There is a need to reduce unnecessary antibiotic prescriptions in order to avoid increasing antibiotic resistance. However, patients may be prescribed antibiotics if they are not convinced about the issue and insist on receiving these drugs. Here, we clarify the factors that cause the opinions of Japanese mothers who are not convinced by the fact that antibiotics were not prescribed for their children. We investigated the factors to which these opinions were attributable among these mothers so as to facilitate antimicrobial stewardship. The study participants included mothers with children aged 3 months to 8 years as of September 2020. We employed a mixed-method approach that included a questionnaire and an interview. The questionnaire survey showed that 34.1％ (75/220) of the mothers surveyed were not convinced that antibiotics should not be prescribed. Many of the mothers were part-time and temporary employees and had misconceptions about and excessive expectations from antibiotic use. Seven mothers were interviewed. Qualitative theme analysis of response data revealed factors associated with the opinions of unconvinced mothers. These factors were categorized into 4 themes: “positive experience with antibiotics,” “excessive expectations from antibiotics,” “illness-associated concerns,” and “a lack of dialogue with doctors.” The unconvinced mothersʼ opinions were influenced by excessive expectations from antibiotic use, including misconceptions due to personal experience, concerns caused by illness in children, and a lack of sufficient dialogue with doctors. Hence, to reduce unnecessary antibiotic prescriptions, it is necessary to conduct educational activities to eliminate the aforementioned contributing factors and increase awareness about the issue.