Babies with Bugs

Babies with Bugs

Pharmacists have few more regular customers than parents who choose to put their young children in day care.  For these are people who make very frequent purchases of antibiotics.  To determine the exact frequency of these purchases, researchers at the Danish Epidemiology Science Centre at the University of Aarhus recently scrutinized data from 5035 Danish children born in 1997 and followed from birth to June 30, 1999.  Because of the large size of their data set and because of their population-based study design, the researchers "obtained very precise risk estimates" in their evaluation of antibiotic use among Danish children.  In these risk estimates, readers may see a sobering warning as to the dangers of substituting day care for parental care.

 Comparing children cared for in their own homes with children cared for in day care, the Danish scholars discovered that "enrollment in a day-care setting doubled a child's risk of receiving a prescription" for antibiotics, with an adjusted relative risk of 2.0 in a day-care center and of 1.9 in a day-care home.  Predictably enough, "the use of S[ystematic] A[ntibiotics] was lowest among children cared for at home."

In a country as reliant upon day care as Denmark, the finding of sharply elevated antibiotic use among day-care children alarms the researchers for several compelling reasons.  First, the use of antibiotics is "a morbidity parameter," indicative of the "increased risk of infectious disease in day-care centers."  Second, the infections for which antibiotics are necessary "may give rise to long-term complications, such as mastoiditis and hearing loss after otitis media."  Third, "increased transmission of infectious agents [among day-care children] may also result in excess illness among parents, day-care workers, and other children."  Finally, since "use of antibiotics is associated with antimicrobial resistance," day-care centers may be helping to incubate deadly new strains of super-bugs.

The authors of the new study acknowledge that day-care kids may be receiving a lot of antibiotics not only because day-care centers spread disease but also because employed mothers "may be more disposed to ask for antibiotics for their children to shorten the amount of time that they have to stay away from work."  In any case, the Danish epidemiologists are so dismayed by the surge in antibiotic prescriptions for Danish children that they urge the "extension of parental leave" to at least one year so that fewer young children will end up in day care and in consequent need of antibiotics.

Other options-such as that of helping fathers to earn enough to support a stay-at-home mother-might suggest themselves to American readers seeking ways to keep children out of harm's way.

(Source: Nana Thrane et al., "Influence of Day Care Attendance on the Use of Systemic Antibiotics in 1- to 2-Year-Old Children," Pediatrics 107[2001]: www. pediatrics.org/cgi/content/full/107/5/e76.)