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Parental experience of prophylactic antibiotics
  1. Simon Jonathan Hardman1,
  2. Fiona Shackley2,
  3. Alison Condliffe3,
  4. Kelechi Ugonna4,
  5. Andrew Lee5
  1. 1Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
  2. 2Paediatric Immunology, Allergy and Infectious Diseases, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
  3. 3Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
  4. 4Paediatric Respiratory Medicine, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
  5. 5Public Health, The University of Sheffield School of Health and Related Research, Sheffield, UK
  1. Correspondence to Dr Simon Jonathan Hardman, Sheffield Children's Hospital NHS Foundation Trust, Sheffield S10 2TH, UK; simonhardman{at}


Background and objectives Long-term prophylactic antibiotics are often used to prevent bacterial infections. However, supporting evidence for this is not always robust. Including parents in decisions relating to medication is key to medicines optimisation. Parental concern regarding medication is a major determinant of poor adherence. This study explores parental experiences of having a child prescribed prophylactic antibiotics and how that affects their antibiotic use behaviour.

Methods We conducted a prospective, single-centre, exploratory, qualitative study at Sheffield Children’s Hospital. Through 15 interviews, involving 18 participants, we explored parental ‘lived experiences’ and attitudes towards azithromycin prophylaxis prescribed for various respiratory conditions. Thematic analysis was conducted.

Results The overriding factor influencing parental decisions about the uptake of antibiotic prophylaxis is wanting their child to be well now. The main concern voiced by parents is that of antibiotic resistance given their children are high users of antibiotics. This is however seen as a problem for the future, not the present. Preparing families adequately helps prevent practical difficulties relating to medication. Facilitating ‘normalisation’ of prophylaxis through daily routines and minimising disruption to the family environment may reduce parental anxiety, promote adherence and result in easing of potential restrictions to the child’s daily activities.

Conclusion Grounded in our deeper understanding, we propose a behavioural model that describes phases parents go through while having a child on prophylactic antibiotics. Time invested in holistically addressing the parental experience and having an awareness of potential issues parents face, may facilitate medication adherence, reduce anxieties and improve doctor-parent relationships.

  • general paediatrics
  • respiratory
  • qualitative research
  • patient perspective
  • paediatric practice

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  • Contributors FS conceived the idea. All authors contributed to the study design. SJH conducted the interviews. AL and SJH conducted the initial analysis and developed the framework of themes. AC, FS and KU contributed to the final analysis. SJH drafted the manuscript.

  • Funding This research was supported by the Bassetlaw clinical research fellowship scheme, post reference no. 50059609, and the charity Antibiotic Research UK, ANTSRG 03/2018.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was granted by North West—Haydock Research Ethics Committee (Reference 18/NW/0579).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. The anonymous transcripts generated and analysed during this study are available from the corresponding author on reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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