Day care and the incidence of otitis media in young children

Marx, Jonathan; Osguthorpe, David J.; Parsons, Gregory

doi:10.1016/s0194-5998(95)70178-8

Cited by 55 publications

(42 citation statements)

References 13 publications

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“…Day care attendance is associated with frequent respiratory infections, some of which are accompanied by AOM. 5,6 Several studies have shown that access to care for children has improved with approximately 90% of parents indicating that their children have a regular source of care. 7,8 We believe that improved access to care is accompanied by increased diagnoses of minor infections and increased oral antibiotic use.…”

Section: Discussionmentioning

confidence: 99%

“…3 The incidence of AOM is increasing, as evidenced by the doubling of prescriptions written for AOM in the last decade from 12 million in 1980 to 24 million in 1992. 4 This increase in antibiotic usage is likely due to a number of factors, including increase in real disease, due in part to widespread day care attendance, 5,6 improved access to care, 7,8 and overprescription of antibiotics.…”

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confidence: 99%

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Parents’ and Physicians’ Views on Antibiotics

1997

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ABSTRACT. Objective. To describe parents' opinions and concerns about antibiotics and to contrast these opinions with those of pediatricians.Design. Parents were surveyed using an intervieweradministered questionnaire and pediatricians were mailed a self-administered questionnaire.Results. Parents from two private practices (N ‫؍‬ 300) were largely white (84%) and had completed college (81%). The parents from a community health center (N ‫؍‬ 100) were mostly black (80%) and had not completed college (91%). Twenty-nine percent of parents were worried that their children were receiving too many antibiotics. Eighty-five percent believed there were problems with receiving too many antibiotics, with 55% mentioning resistance or immunity as concerns. Eighteen percent of parents had given their child an antibiotic at home before consulting a physician. Parents believed that antibiotics were always or sometimes required for ear infections (93%), throat infections (83%), colds (32%), cough (58%), and fever (58%). Fourteen percent of parents believed that their child had required an antibiotic when the doctor did not prescribe one, with clinic parents significantly more likely to report this issue (22%) than private practice parents (12%). Nine percent believed that their doctor had prescribed an antibiotic unnecessarily (private practice ‫؍‬ 12%, community health center ‫؍‬ 3%). Parents from the private practices were also more likely to report requesting a specific antibiotic (34%) in comparison with 19% of clinic parents.Sixty-one percent of the physician surveys were returned after two mailings and a follow-up phone call. The pediatricians had been in practice for a median of 12 years, seeing a median of 110 patients per week. Fiftyeight percent of pediatricians reported that some, many, or most of the parents in their practices were worried that their children were receiving too many antibiotics. Seventy-one percent indicated that four or more times during the previous month, a parent had requested an antibiotic when the physician believed it was unnecessary, and 35% said that at least occasionally they went along with these requests. Sixty-one percent reported that parents requested a different antibiotic from the one they were going to prescribe at least four times in the previous month, and 30% of pediatricians said that they agreed to parents' requests often or most of the time.Conclusions. Both the parent and the physician surveys suggest that parents are concerned about the overuse of antibiotics, but often request them when their physicians believe they are unnecessary. Parents often administer antibiotics without physician knowledge, and many parents have misconceptions about which illnesses warrant antibiotic therapy. Understanding parents' concerns and beliefs about antibiotics and the range of physician practice styles with respect to antibiotics may direct the development of intervention strategies to reduce the inappropriate use of oral antibiotics. Pediatrics 1997; 99(6). URL: http://www.pediatrics.org/...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Parents’ and Physicians’ Views on Antibiotics

1997

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“…It has been indicated that early and massive nasopharyngeal colonization with potentially pathogenic bacteria may p1ay a role in the pathogenesis of OM especially in high risk populations (Leach et al 1994, Homøe et al 1996. Risk factors in studies from other parts of the world include race, male gender, cleft palate, young age at first AOM, episode, siblings in the household with URTI, parental history of OM, attendance in large size daycare centers, exposure to passive smoking, lack of breast feeding, feeding position, atopy, prematurity, use of comforter, poor housing standard, and social poverty (i.e., poor living conditions) (Christensen 1956, Howie et al 1975, Strangert 1977, Ingvarsson et al 1982b, Saarinen 1982, Vinther et al 1982, Ståhiberg et al 1986, Fleming et al 1987, Kero and Piekkala 1987, Shapiro 1988, Harsten et al 1989, Teele et al 1989, Alho et al 1990, Froom and Culpepper 1991, Duncan et al 1993, Bastos 1994, Aniansson et al 1994, Ey et al 1995, Marx et al 1995, Sorri et al 1996, Uhari et al 1996, Kvaerner et al 1997aand b, Stenstrom and Ingvarsson 1997a, Daly et al 1999. However, results are conflicting for several of these risk factors, and most have only slightly been found to increase the risk for AOM.…”

Section: Aimsmentioning

confidence: 99%

Otitis Media in Greenland: studies on historical, epidemiological, microbiological, and immunological aspects

Homøe¹

2001

International Journal of Circumpolar Health

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“…[1][2][3] Children in child care center settings have more upper respiratory infections, diarrheal illness, ear infections, and myringotomy tube placement than children who stay at home exclusively. [4][5][6][7] Previous research demonstrates that ill children are routinely excluded from child care unnecessarily given that most child care-related illnesses are minor in severity. [8][9][10][11] Unnecessary exclusions place a substantial burden on working families, businesses, and health care resources.…”

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confidence: 99%

Emergency Department and Urgent Care for Children Excluded From Child Care

Hashikawa¹,

Brousseau

Singer

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Previous studies have revealed that children in child care are frequently ill with mild illness and are unnecessarily excluded from child care at high rates.WHAT THIS STUDY ADDS: Parent race/ethnicity, single parents, and work-related concerns are associated with increased emergent/urgent care use for a sick child excluded from child care, even for mild illnesses.abstract BACKGROUND: Children in child care are frequently unnecessarily excluded for illness. We investigated parental use of urgent medical evaluation for sick children unable to attend child care. METHODS:In May 2012, authors conducted a nationally representative survey of parents, who completed online questions regarding child illness causing absence from child care and their medical care-seeking behavior. Main outcome was parents' use of emergency department or urgent care (ED/UC). RESULTS:Overall survey participation rate was 62%. Of participating parent cohort with children 0 to 5 years old, 57% (n = 357) required child care, of which 84% (n = 303) required out-of-home child care. Over 88% of parents sought acute medical care for their sick children unable to attend child care. Approximately one-third of parents needed a doctor' s note for employers and/or child care. Parents sought medical evaluation (.1 option possible) from primary care (81%), UC (26%), or ED (25%). ED/UC use was most common for rash (21%) and fever (15%). Logistic regression indicated ED/UC use was significantly higher among single/divorced parents (odds ratio [OR] = 4.3; 95% confidence interval [CI]: 2.5-13.5); African American parents (OR = 4.2; 95% CI: 1.2-14.6); parents needing a doctor' s note (OR = 4.2; 95% CI: 1.5-11.7); and those with job concerns (OR = 3.4; 95% CI: 1.2-9.7).CONCLUSIONS: A substantial proportion of parents whose sick children cannot attend child care seek care in ED/UC. Training child care professionals regarding appropriate illness exclusions may decrease ED/UC visits by lowering child care exclusions. Pediatrics 2014;134:e120-e127 AUTHORS:

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Day care and the incidence of otitis media in young children

Cited by 55 publications

References 13 publications

Parents’ and Physicians’ Views on Antibiotics

Parents’ and Physicians’ Views on Antibiotics

Otitis Media in Greenland: studies on historical, epidemiological, microbiological, and immunological aspects

Emergency Department and Urgent Care for Children Excluded From Child Care

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