# Prevalence and Predictors of Using Antibiotics Without a Prescription in Pediatric Populations

> **NIH AHRQ R03** · BAYLOR COLLEGE OF MEDICINE · 2020 · $100,000

## Abstract

Non-prescription antibiotic use in children is an understudied problem. This practice includes obtaining and
taking antibiotics without a prescription (e.g., from stores or flea markets in the United States (U.S.) or abroad),
taking another person’s antibiotics, or taking one’s own stored antibiotics for an indication other than for which
the antibiotic was originally prescribed. In our 2019 scoping review, we found only three studies exploring non-
prescription antibiotic use in children in the U.S. One of these studies was a 2018 national internet survey,
finding that 92% of surveyed parents had leftover pediatric antibiotics from previous prescriptions and 73%
stated that they subsequently gave the antibiotics to the child’s siblings, unrelated children, parents themselves
and unrelated adults. Our scoping review generated considerable press interest, as the problem has barely
been described in the U.S. Non-prescription use increases the risk of development of antibiotic resistance,
adverse drug reactions, and other harms. Children are more vulnerable to the problem of resistance, as they
have a higher incidence of infections and receive more antibiotics than adults. In addition, many antibiotics
have not been approved for pediatric use, thus limiting treatment options. Antibiotic use in children has also
been associated with an increased risk of asthma, obesity, juvenile idiopathic arthritis, and reduced
microbiome diversity. Low-income populations are at higher risk of developing antibiotic-resistant infections,
putting low income children at further risk. There is a critical need to study the prevalence, sources and
characteristics of non-prescription use in children to guide development of a stewardship intervention. The
overall objective of this project is to study the prevalence and predictors of pediatric non-prescription use in
racially/ethnically diverse caregivers of children under 18 years in safety net clinics and lay the foundation for
our subsequent intervention. We will use the Kilbourne et al. conceptual framework for advancing health
disparities research to identify the predictors of non-prescription use. In Aim 1A, we will administer a survey in
English and Spanish to children’s caregivers to estimate the prevalence of giving non-prescription antibiotics to
children. We will explore antibiotics obtained from a range of sources, including stores in the U.S. or other
countries, leftover prescribed courses, and family or friends. We will also investigate symptoms that trigger
non-prescription use in children, specific antibiotics used, duration of use and storage of pediatric antibiotics. In
Aim 1B, we will assess how caregivers’ sociodemographic factors and health literacy are associated with
decisions to use non-prescription antibiotics. Our team includes an epidemiologist, an infectious diseases
physician, and a pediatrician working in our safety net pediatric clinics. The proposed research is innovative,
because it will prov...

## Key facts

- **NIH application ID:** 10108960
- **Project number:** 1R03HS027869-01
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Larisa Grigoryan
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $100,000
- **Award type:** 1
- **Project period:** 2020-09-30 → 2022-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10108960

## Citation

> US National Institutes of Health, RePORTER application 10108960, Prevalence and Predictors of Using Antibiotics Without a Prescription in Pediatric Populations (1R03HS027869-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10108960. Licensed CC0.

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