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Day Care Workers Prescribing Too Many Trips to the Doctor

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WebMD Health News

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.

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