NPS Media Releases – 1. Raising Antibiotic Awareness in Childcare Centres 2. Otitis Media- Clarifying Prescribing

6 JULY 2016

NPS MedicineWise has written to child care centres across Australia to enlist their support in responding to the growing problem of antibiotic resistance. Child care staff are well placed to help with education and increase awareness around the misuse of antibiotics in young children. 

This winter NPS MedicineWise is reminding Australian parents and carers that antibiotics don’t work on cold or flu viruses, and young children could be taking these medicines unnecessarily. Using antibiotics for ordinary cold and flu contributes to antibiotic resistance which is a growing public health problem.

NPS MedicineWise CEO Dr Lynn Weekes says that while awareness of appropriate antibiotic use is growing in the community, many parents under pressure to get back to work or to get their child back to child care are often still expecting an antibiotic prescription to treat viral cold and flu symptoms.

“No-one likes seeing a child unwelI with a cold or flu, but it is important for parents and carers to understand how to best manage their symptoms and that antibiotics aren’t a quick fix,” says Dr Weekes.

“In most cases, children just need rest and time to allow their immune system to fight the virus. Another common misconception is that antibiotics will speed up recovery from cold and flu viruses in both children and adults—but they don’t.”

Antibiotic resistance and children

With any course of antibiotics, there is a risk of developing antibiotic-resistant bacteria. Once they develop, antibiotic resistant bacteria can stay in the child’s body for up to a year and be passed on to others. This is another key reason why it is important to avoid antibiotics unless there is a bacterial infection that won’t clear up on its own.

Green snot

A common belief in the community and outlined in some individual child care centre guidelines is that if a child has green snot, they should be prescribed antibiotics. Green snot doesn’t mean an antibiotic is required. Green or yellow coloured nasal discharge can in fact be a sign that the immune system is fighting the infection, and not that a viral illness is getting worse.

Antibiotic side effects

Like any medicine, antibiotics can cause side effects. Common side effects include vomiting, diarrhoea, thrush infection and can also include allergic reactions (such as hives). Antibiotic-associated diarrhoea is particularly common in children taking a course of antibiotics.

If taken for a viral illness, antibiotics will not help the illness, but can cause damage to ‘good’ bacteria like those found in the gut. Scientists are only just discovering how gut bacteria affect overall health. It takes time for these good bacteria populations to regenerate in a child’s body after a course of antibiotics. 

If parents are concerned about their child, they should take them to a doctor for a check up, but if the child has a viral infection, they should not expect the result of the consultation to be a prescription for antibiotics.

Dr Weekes says, “Child care centres are encouraged to promote to their families how to manage the symptoms of colds and flu without antibiotics, as well as check that their individual centre policies, such as excluding children with green nasal discharge, are not leading to any possible misuse of antibiotics.”

“This winter we are encouraging parents to not ask for antibiotics for ordinary colds and flu,” says Dr Weekes. “It’s an important step to protect the miracle of antibiotics not just for their children, but also for future generations.”

Child care centres will find further information and resources to share this winter, including a drawing competition with book prizes at


8 JULY 2016

With cold and flu season underway, NPS MedicineWise has released an interactive online case study tailored by audience to GPs, pharmacists and nurses on otitis media and antibiotic prescribing.

In Australia, 84% of acute otitis media (AOM)/middle ear infection is treated with antibiotic therapy, contributing to increasing antibacterial resistance in Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, the most common bacterial otitis media otopathogens. It is usually a short-term infection.

Dr Andrew Boyden , NPS MedicineWise medical adviser says, “Increasingly, the limited role of antibiotics for the treatment of acute otitis media is being recognised, which is reflected in contemporary clinical guideline recommendations.

“Health professionals have an important role to play in raising awareness about antibiotic resistance and prescribing issues. This includes helping parents and carers of children with acute otitis media understand both the potential benefits as well as harms of antibiotics that need to be considered when making prescribing decisions. 

“Many parents may not be aware that antibiotics have limited effect on early pain and may not fully appreciate the risk of side effects—such as diarrhoea. 

“In scenarios such as children presenting with a sore ear, many parents consult their GP for reasons other than to request antibiotics. This is often for reassurance, for information about their condition or to rule out more serious illness. Reassurance as well as providing guidance on symptomatic management options are important aspects of management of ear infections.”

The case study Otitis Media: Clarifying the role of antibiotics presents two clinical scenarios and covers initial treatment options, discussions on the role of antibiotic treatment, the role for delayed prescriptions, minimising the risk of AOM recurrence and when to refer to an ENT specialist. The case study has expert commentary from Professor Chris Del Mar, GP and Professor of Public Health, Bond University.

Learning outcomes for participants include :

  • Outlining of recommended pharmacological management of acute otitis media (AOM)
  • Identification of appropriate prevention strategies for otitis media
  • Recognition of when antibiotic therapy may be needed in patients with AOM. 

NPS MedicineWise case studies are free and offer continuing professional development (CPD) points for GPs, pharmacists and nurses. For GPs, the case study is recognised for the Practice Incentives Program Quality Prescribing Incentive.

Choosing Wisely Australia®

The prescribing of antibiotics for middle ear infection in children was addressed in a recent recommendation from the health profession-led initiative Choosing Wisely Australia, facilitated by NPS MedicineWise. The Royal Australian College of General Practioners (RACGP) recommended against routine use of antibiotics for children aged 2 to 12 years (who aren’t of Aboriginal and Torres Strait Islander descent) where reassessment was a reasonable option.

For more information about the case study, visit

More information about the Choosing Wisely Australia recommendation is available here.


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