A1 Refereed original research article in a scientific journal

The impact of day care attendance on antibiotic use among children aged 0–12 years: A population-based register study




AuthorsRäsänen, Tapio; Saarikallio-Torp, Miia; Rättö, Hanna; Kari, Heini

PublisherPLOS

Publication year2025

Journal: PLoS ONE

Article numbere335354

Volume20

Issue11

eISSN1932-6203

DOIhttps://doi.org/10.1371/journal.pone.0335354

Publication's open availability at the time of reportingOpen Access

Publication channel's open availability Open Access publication channel

Web address ttps://doi.org/10.1371/journal.pone.0335354

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/505416145


Abstract

Day care attendance is known to be an important source of infection transmission in children. Having older siblings has also been shown to increase the risk of recurrent infections. We use comprehensive register data to study if the cumulative antibiotic use in children differs according to the duration of how long the child has been in home care before entering day care. The study focuses on children born in Finland between 2000 and 2005, with follow-up until age 12. Children are linked to their biological parents, and the analysis includes control variables such as mother’s age and education level. In addition to descriptive evidence, we employ statistical models to study the association between the duration of home care and antibiotic exposure. The results show that almost all children were exposed to prescribed antibiotics within the first 12 years of their life. One fifth of the children had more than 15 antibiotic purchases by the age of 12. Four most commonly prescribed antibiotics were amoxicillin, azithromycin, cefalexin, and amoxicillin with beta-lactamase inhibitor. The results from Poisson regression model affirmed that cumulative use was lower in children with longer home care duration. Regardless of the number siblings, the number of cumulative antibiotic purchases remained lowest in the group of children with the longest home care period, and the results remained robust after controlling for the mother’s age and education, and immigrant background. These findings contribute to a broader understanding of how early childhood care arrangements may be associated with long-term patterns of antibiotic use, with potential relevance for public health planning and antimicrobial stewardship.


Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.




Funding information in the publication
The author(s) received no specific funding for this work.


Last updated on 18/11/2025 10:44:37 AM