Day Care Workers Prescribing Too Many Trips to the Doctor
Feb. 15, 2000 (Atlanta) -- A new study confirms what many working parents
know to be true. Day care center staff too often pressure parents to take their
child to a physician, get antibiotics, or just stay at home with their child
without adequate reason. The Canadian study is published in this month's
Archives of Pediatrics and Adolescent Medicine.
"It looks like there is poor knowledge on the part of the day care
directors, and they tend to encourage antibiotics for attendees,"
corresponding author Elaine E.L. Wang, MD, tells WebMD. "There's no
question they need better education."
Children experience many illnesses during childhood. Most childhood
illnesses, such as the common cold, are caused by viral infections. Children
normally recover from common viral infections when the illness has run its
course. Antibiotics should not be used to treat viral infections.
Antibiotics do treat bacterial infections, however. Over time, bacteria can
become resistant to antibiotics, and overuse of the medications is often a
factor in that resistance. The authors note that "strategies are needed to
reduce unnecessary antibiotic prescriptions, the major contributor to the
escalating problem of antibiotic-resistant bacteria."
In the study, researchers conducted telephone interviews with providers in
36 day care centers in Canada. They questioned the providers on their knowledge
and attitudes about antibiotic use for children and how often they referred
children to physicians for examination.
From the interviews, the researchers found that more than 90% of the day
care staff reported sending diapered children home if they had an infection and
were not able to participate in center activities.
More than 75% of the staff members reported advising a physician visit when
nasal discharge was colored, and more than 50% recommended a visit to a
physician for children with coughs.
A majority also reported sending children home "to prevent the spread of
infection" (67%) or if there was insufficient staff to care for the
children (61%). On the other hand, most staff members (69%) kept children at
the center who, they felt, needed to be home if the child had an antibiotic
prescription and their parents could not stay home from work.
In children who were suspected of having an upper respiratory infections,
nearly 40% of the officials at the centers said they believed antibiotics would
be helpful in preventing bacterial infection, 26% thought antibiotics were
useful to prevent infection spread, and 21% believed antibiotics could speed up
the child's recovery.
"Few knew that antibiotics aren't effective in speeding recovery or
preventing the spread of viruses associated with upper respiratory tract
infections," says Wang. Wang is vice president of clinical and medical
affairs for Aventis Pasteur, Canada -- a pharmaceutical firm -- and is also an
associate professor in the departments of pediatrics and public health sciences
at the University of Toronto.