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[e-drug] Kindergartners Help Decrease Inappropriate Antibiotic Use

E-DRUG: Kindergartners Help Decrease Inappropriate Antibiotic Use 

We all know that AMR is a global problem exacerbated by inappropriate use of 
antibiotics, especially for common viral illnesses such as colds and flu. 
Inappropriate use is especially likely in countries where antibiotics are 
available over-the-counter. This suggests that the primary target for education 
should be consumers where incentives for ?doing the right thing? include saving 
the money wasted on antibiotics. Thus, I am delighted to tell you about an 
innovative program that convinced me that kindergarten children can help solve 
the problem of inappropriate use of antibiotics for colds and flu. This program 
was conceived by Natalia Cebotarenco, MD, PhD, director of DrugInfo Moldova.

A questionnaire previously given to the children?s mothers by Dr. Cebotarenco 
indicated that 72% of the children had a cold or flu the prior winter and 76 % 
of these had been given an antibiotic with 69% obtained via a doctor?s 

I spent June 4-7 in two Moldovan cities, Tiraspol and Bricini. In Tiraspol, I 
saw children from 18 kindergartens present a program, 'Don?t take antibiotics 
for colds and flu' as part of an international conference, Global Priorities 
for Children: Medicine Education and Better Medicines. Each kindergarten 
developed its own presentation consistent with the primary message. Tiraspol?s 
community auditorium was filled with parents, teachers, hospital directors, 
physicians, pharmacists, administrators, the district chairman, and the media. 
Two days later, a similar program was presented by three pilot kindergartens in 
Bricini.  Clearly, an advantage of having the program in kindergarten is that 
parents will come to see their children perform. In higher grades, parents are 
less likely to attend.

For some of the skits, the children were costumed as viruses, bacteria, and 
antibiotics, with the larger bacteria killed by the antibiotics while the 
viruses survived. An adult Dr. Doolittle figure helped the children and 
reinforced the message. Early on, some of the children ran through the audience 
blowing bubbles 'to spread their cold and flu viruses.'  Parents were called to 
the stage to answer questions by lining up behind signs (Yes, No, DK), e.g., Do 
antibiotics kill viruses?  Prevention was urged via fruits, vegetables, washing 
hands, and using disposable tissues. The message was given over and over in 
entertaining presentations, "Don't take antibiotics for colds and flu." I doubt 
anyone there could ever forget this message. 

After the program, which also included presentations on the "why, who, how, 
when and where" of teaching children about medicines, the attendees met in 
multidisciplinary groups and planned for the future. All groups wanted to 
extend the program to all kindergartens and teach children about medicines up 
through the school grades. 

The attendees were pleased to learn about the Finnish curriculum (available 
without charge in Finnish and in beta testing in English 
www.uku.fi/medicinescurriculum) and plan to have it translated into Russian and 
Romanian. This curriculum is based on USP?s Guide to Developing and Evaluating 
Medicine Education Programs for Children and Adolescents published by the 
United States Pharmacopeia (www.USP.org) and the American School Health 

We met later in Moldova?s capital, Chisinau, with the Minister of Health and he 
pledged his cooperation in extending medicine education to all schoolchildren 
and to support training physicians and pharmacists to communicate with 
children. We think Moldova may be the second country (after Finland) to mandate 
that children be taught about medicines.

For more information contact Natalia Cebotarenco, MD, PhD, at DrugInfo Moldova 
(epn.nis@yahoo.com) or me (pjbushwork@comcast.net).

Patricia J. Bush, PhD
Professor Emeritus Georgetown U. School of Medicine
6825 Grenadier Blvd 
APT 1405 
Naples, FL 34108-7218 
Tel: 239-591-8550 

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