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PEDIATRICS Vol. 107 No. 5 May 2001, p. e76

ELECTRONIC ARTICLE:
Influence of Day Care Attendance on the Use of Systemic Antibiotics in 0- to 2-Year-Old Children

Received Sep 26, 2000; accepted Dec 21, 2000.

Nana Thrane*, Dagger , Charlotte Olesen*, Jens Tølbøll Mortensen MD§, Charlotte Søndergaard*, Henrik Carl Schønheyder§, parallel , and Henrik Toft Sørensen§,

From the * Danish Epidemiology Science Centre at the Department of Epidemiology and Social Medicine, University of Aarhus, Dagger  Medical Research Unit, Ringkjøbing County, § Department of Clinical Epidemiology at Aalborg Hospital and University of Aarhus, Aarhus; parallel  Department of Clinical Microbiology, Aalborg Hospital, Aalborg; and the  Department of Medicine V, Aarhus University Hospital, Aarhus C, Denmark.

Objective.  To examine the association between time spent in different public day care settings and prescription of systemic antibiotics.

Design.  Population-based cohort study of 5035 Danish children born in 1997 followed from birth to June 30, 1999.

Methods.  The study was performed by the linkage of records drawn from administrative registries. Exposure was the total time spent in a day care home or day care center. Outcome was the first prescription of a systemic antibiotic. Possible perinatal and sociodemographic confounding factors were considered by statistical analysis.

Results.  During the first year of life, 39.8% of the girls and 51.1% of the boys received at least 1 antibiotic prescription drug. Enrollment in a day care setting doubled a child's risk of receiving a prescription drug (adjusted relative risk in day care home 1.9, 95% confidence interval: 1.7-2.0; adjusted relative risk in day care center 2.0, 95% confidence interval: 1.7-2.3). Only age confounded the analyses. Age >1 year at the starting time in day care reduced the risk of receiving antibiotic prescriptions during the first 3 months after enrollment.

Conclusions.  Enrollment in public day care facilities raised the risk of receiving an antibiotic prescription drug to the same extent in day care homes as well as in day care centers, so we cannot recommend one facility over the other based on the present study. Children <1 year old at enrollment were most at risk, suggesting that extension of parental leave may reduce the use of antibiotics.  Key words:  day care settings, antibiotic use, infectious diseases, children, prescription drug..


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