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
(firstname.lastname@example.org) or me (email@example.com).
Patricia J. Bush, PhD
Professor Emeritus Georgetown U. School of Medicine
6825 Grenadier Blvd
Naples, FL 34108-7218