Medication and Antibiotic Use Among Children Reported by an Online Convenience Sample of Parents in Serbia: A Cross-Sectional Survey

Background: Parents play a central role in medication use in children. Given the limited evidence in our setting, this study aimed to characterize and identify factors associated with antibiotic use and parent-directed medication without physician recommendation in Serbia. Methods: A cross-sectional online survey was conducted among an online convenience sample of parents or guardians of children younger than 12 years. The questionnaire collected sociodemographic data, information on medication and antibiotic use in the youngest child, sources of treatment recommendations, and parental knowledge and attitudes toward antibiotics. Factors associated with antibiotic use and parent-directed medication without physician recommendation were examined using multivariable modified Poisson regression with robust standard errors, with adjusted prevalence ratios (aPRs) and 95% confidence intervals reported. Results: A total of 1268 parents/guardians participated. Medication use during the previous six months was reported for 900/1268 children (71.0%, 95% CI: 68.4–73.4%), while 693/1268 (54.7%, 95% CI: 51.9–57.4%) had received antibiotics. During the last infection, the use of second- and third-generation cephalosporins (30.3%), co-amoxiclav (28.3%), and amoxicillin (20.8%) were most commonly reported. Higher prevalence of antibiotic use was associated with toddler age, kindergarten or school attendance, and chronic illness. Only five respondents (0.4%) reported parent-directed antibiotic administration without physician recommendation. In contrast, parent-directed medication without physician recommendation was reported for 514/900 children who had used medicines (57.1%, 95% CI: 53.9–60.3%), and higher prevalence was associated with preschool age, higher parental education, and parent being a healthcare professional, and lower prevalence with infancy and chronic illness. Conclusions: Medication use and parent-directed medication without physician recommendation were common, whereas parent-directed antibiotic use without physician recommendation was rarely reported among this online convenience sample of parents in Serbia.