Document Type

Journal Article

Publication Title

Journal of Advanced Nursing




School of Nursing and Midwifery




AMR Aware Inc / Australian Rotary Health


Alejandro, A. L., Bruce, M., & Leo, W. W. C. (2023). Changes in parental anxiety and intention to demand antibiotics: A longitudinal study among parents during the COVID-19 pandemic. Journal of Advanced Nursing. Advance online publication.


Aims: Assessing the effects of the COVID-19 pandemic on parental anxiety and preferences for antibiotic treatment can help inform antibiotic stewardship strategies. Therefore, this study aimed to examine COVID-19 pandemic-related changes in parental anxiety levels, their intentions to demand antibiotics and frequencies of practising preventative behaviours. Design: This longitudinal quantitative study compared two groups of parents, those from Victoria and Western Australia, who experienced high and low COVID-19 risk, respectively. Methods: Participants were recruited through an online panel to complete three waves of surveys between October 2020 and August 2021. Anxiety scores and frequency of preventative behaviours were analysed using mixed-effects tobit regression, considering time, state, and their interaction as fixed effects predictors. Intention to demand antibiotics was modelled using multinomial logistic regression, with time, state, and their interaction as the predictors. Results: The final longitudinal sample comprised 50 participants from Victoria and 51 from Western Australia. Parental anxiety did not significantly change over time for either state. Intention to demand antibiotics was also stable over time within each state; however, participants from Victoria exhibited stronger intentions to demand antibiotics compared to those from Western Australia. Frequencies of parental preventative behaviours declined from Wave 1 to Wave 2 before increasing again in Wave 3, but only for Western Australia. Conclusion: This longitudinal study among Australian parents found stable parental anxiety and intention to demand antibiotics within each state. However, the intention to demand antibiotics and preventative behaviours varied between states as per the COVID-19 risk. Thus, viral pandemics may not affect judicious antibiotic use, though the intention to demand antibiotics may increase in states with high COVID-19 risk. Impact: Though parental anxiety may not impact antibiotic stewardship during viral respiratory illness outbreaks, tailored messaging to maintain appropriate antibiotic use may be necessary, especially when the disease risk is high.



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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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