title: Nursery sickness policies and their influence on prescribing for conjunctivitis: audit and questionnaire survey.
abstract: BACKGROUND
  Acute infective conjunctivitis is common among preschool children. Public Health England (PHE) recommends that children with conjunctivitis do not need to be excluded from child care, but childcare providers are required to determine their own sickness policies and prior research suggests that children are often excluded until they are treated or have recovered. How the content of these policies impacts on prescribing decisions has not been quantified.
  
  
  OBJECTIVE
  To assess the content of childcare providers' sickness policies and determine the impact they have on clinicians' prescribing.
  
  
  METHODS
  An audit of childcare providers' sickness policies and a questionnaire among primary care clinicians.
  
  
  METHODS
  Sickness policies from childcare providers across the UK were compared with PHE guidance. Clinicians completed a questionnaire on the impact that childcare provider policies have on their decision to prescribe antibiotics to preschool children with conjunctivitis.
  
  
  RESULTS
  Of 164 policies examined, 86.7% excluded children with conjunctivitis and 49.4% of policies specified a requirement for antibiotics. Two-hundred clinicians completed questionnaires and 42.6% replied that they had been influenced by childcare policies when deciding whether to prescribe antibiotics in this scenario. Furthermore, 15.4% admitted that childcare policies had been the only reason they prescribed antibiotics.
  
  
  CONCLUSIONS
  Most of the childcare providers' sickness policies contain requirements that are inconsistent with PHE guidance. The requirements of childcare sickness policies are likely to be resulting in unnecessary primary care consultations and thousands of prescriptions for antibiotics with little demonstrable clinical or public health benefit.
authors.forename: Samuel
authors.initials: S
authors.lastname: Finnikin
authors.forename: Kate
authors.initials: K
authors.lastname: Jolly
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002656:Child Day Care Centers / Q000458:organization & administration*; D002675:Child, Preschool; D054869:Clinical Audit; D003231:Conjunctivitis / Q000175:diagnosis / Q000188:drug therapy*; D004739:England; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010290:Parents; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotics; child care; conjunctivitis; primary health care