Antibiotic use among 8-month-old children in Malmo, Sweden - in relation to child characteristics and parental sociodemographic, psychosocial and lifestyle factors

Background: In the county of Scania, Sweden, antibiotic use among small children is among the highest in the country. The aim of this study was to investigate the associations between antibiotic use among 8-month-old children in Malmo and characteristics of the child as well as parental sociodemographic characteristics, lifestyle factors, and psychosocial support. Methods: The study was a population-based cross-sectional survey. The study population consisted of children who visited the Child Health Care (CHC) centres in Malmo for their 8-month health checkup during 2003-2006 and whose parents answered a self-administered questionnaire (n=7266 children). The questionnaire was distributed to parents of children registered with the CHC and invited for an 8-month checkup during the study period. Results: The odds of using antibiotics increased as parental educational level decreased. Using high educational level as a reference group, low maternal educational level was associated with an increased antibiotic use for the child, odds ratio (OR) =1.61 (95% CI: 1.34-1.93). Furthermore, children whose parents were born outside Sweden showed higher antibiotic use, OR = 1.43 ( 95% CI: 1.24-1.65), in comparison with children whose parents were born in Sweden. Exposure to environmental smoking, parental experience of economic stress, and a low level of emotional support increased the odds for antibiotic use. Boys had higher odds of use of antibiotics than girls, OR = 1.40 (95% CI: 1.25-1.57). Having a low birth weight, having an allergy and having siblings also increased the odds for early antibiotic use, while breastfeeding seemed to have a protective role. Conclusion: There were clear associations between parental factors such as sociodemographic, psychosocial and lifestyle factors and antibiotic use at this early stage of life. Several characteristics of the child also affected the use of antibiotics.