Objective  To investigate antibiotics use among preschool children and relevant cognition among their parents in Ji’nan city of Shandong province for effective health intervention on rational antibiotics use.

  Methods  A total of 362 parents of children aged 0 – 6 years were randomly selected from 5 hospitals and 2 kindergartens in Ji’nan city and administrated with a face-to-face interview using a structural questionnaire between March and May 2016.

  Results  β-lactams antibiotic with relatively high safety dominated antibiotics commonly used among the preschool children and fever was a major symptom inducing antibiotics use among the children, which was reported by 63.54 % (230/362) of their parents. The major method of antibiotic administration was oral medication reported by 54.97 % (199/362) of the parents. There were obvious difference in antibiotics use determined by the parents; 42.54 % (154/362) of the parents reported their child’s antibiotics use without a doctor’s prescription and 36.19 % (131/362) reported self-determined combined use of antibiotics of their children; among the latters, 50.38 % (66/131) had no knowledge about the interaction between the antibiotics administrated to their children. Signs of drug resistance of body normal flora in the children were reported by 35.36 % (128/362) of the parents. The median and mode value for the knowledge score of adverse effect of antibiotics was 2 and 3 of a 5-grade scale among the parents.

  Conclusion  There are abuse of antibiotics and overuse of intravenous antibiotic administration among preschool children in Ji’nan city; in addition, the parents of the children have limited knowledge about antibiotic use and its adverse effect and they do not consider indications of antibiotics administrated to their children. The results suggest specific education on antibiotic use and management on antibiotic retail should be strengthened.