Nursery policies promote antibiotic use in children, study suggests

Nurseries' policies for excluding unwell children are often not evidence-based and pressure children to unnecessarily take antibiotics and miss classes, a UK study suggests.

Children: nurseries demand antibiotic use

Dr Leila Rooshena, of Cardiff University’s institute of primary care and public health looked at policies of 217 day-care providers in south east Wales. She asked providers about their policies and also interviewed a subset of the providers about how their policies had been drawn up.

Dr Rooshena presented the results of her study at the Society for Academic Primary Care and RCGP joint conference in Glasgow earlier this month.

She told GP that, in many cases, the policies were often not evidence-based.

‘The HPA has provided guidance,’ Dr Rooshena said. ‘We used those guidelines as a baseline for what is evidence-based. But we found that not many people were basing their policies on those guidelines.’

Day-care providers’ guidelines were often based on misconceptions and myths about illness and symptoms, she said.

Some suggested antibiotics were a necessary or routine treatment for specific infections, such as conjunctivitis or tonsillitis, and that parents should consult a doctor to obtain antibiotics. Others inappropriately suggested using antibiotics if children had specific symptoms or a 'coloured discharge', such as green phlegm.

Some parents said they had only given their children antibiotics so that the day-care provider would allow the children to attend classes sooner. Another parent said her GP had said antibiotics were unnecessary but had prescribed them anyway when told about the day-care provider’s policy.

Dr Rooshena said the content of the policies showed the need for wider public education about the symptoms and treatment of mild illnesses. ‘We need to get back to basics and educate people about symptoms and get rid of misconceptions,’ she said.

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