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According to experts such as Dr. Murray, the second most common risk factor for antibiotic-resistance in children--after frequent exposure to antibiotics--is early attendance at group child care. At any given time, a significant percentage of young children in a group child-care setting are taking prescribed antibiotics, creating a hotbed for development and transmission of antibiotic-resistant strains of disease.
Duncan Hampton of Knoxville, Tennessee, says that his fourteen-month-old son, Scott, was sick with a string of bacterial and viral illnesses from the time he was placed in child care at the age of six months until his first birthday, at which time his pediatrician strongly advised the Hamptons to remove him from group care to avoid the risk of future antibiotic resistance.
"Our baby was never sick with even a sniffle until he started day care. After that, he was basically on antibiotics for six months straight for one thing or another," says Hampton. "We must have tried eight different types of prescriptions to try to stop the constant ear infections, coughs, and diarrhea. It was only after it was clear that none of it was working that the doctor suggested we remove him from day care. I wish that he had explained how our son could develop resistance to antibiotics before we put him in day care. I think it's a sensitive subject and doctors don't want to seem judgmental about working mothers. At Scott's day care, so many babies were on antibiotics that there was actually a shelf full of bottles of it in his classroom. Almost every baby had his own prescription bottle at one time or another. Parents would talk about which antibiotic was working best for their child."
"Group child care, and particularly large group child-care settings, are often a breeding ground for resistant bacteria, as well as for viral illnesses, which are then sometimes improperly treated with antibiotics," explains Dr. Murray. "We as a society need to rethink putting babies and young children in these child-care centers and increasing their chance of experiencing antibiotic resistance. Parents need to be told about the risks."
Despite his concerns and those of the other members of the AAP's Committee on Infectious Disease, Dr. Murray says he believes the message regarding lowering children's risk for antibiotic-resistant illness is beginning to get out.
"Pediatricians are starting to understand the seriousness of this situation and soon, parents will too," says Dr. Murray. "I am optimistic that attitudes are changing concerning antibiotics. After all, used properly, antibiotics can save a child's life, but used in a less-than-judicious way, they have the potential to do great harm."
Katie Allison Granju is a regular contributor to Minnesota Parent.