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Our Aims:

Conduct a Health and Safety Project among 900 childcare centers enrolled in Pennsylvania Childcare Centers Antibiotics Resistance Awareness Initiative (PA-ARAI).

Survey directors of early learning centers and child care providers and assess their knowledge, practices and opinions regarding antibiotic use.

Implement and evaluate educational interventions to reduce childhood illnesses.

Understand how sick-child exclusion policies contribute to unnecessary use of antibiotics and suggest improvements to current practice.

directors corner

Director's Corner

The United States Census Bureau estimates that Pennsylvania has approximately 8000 licensed child care settings with approximately a quarter million children. Since child care centers are required to follow sick-child exclusion policies, they sometimes require that sick children receive antibiotics before they are readmitted to the center. However this practice promotes inappropriate antibiotic prescribing.

The PA Department of Health is partnering with CDC’s Get Smart campaign to implement and evaluate selected interventions to address factors that drive overuse of antibiotics among children in childcare centers. As the childcare center Director, you have the capacity to make changes within your center and align with the Get Smart movement. It is important to remember that colds and flus do not require antibiotics. The Parents’ Forum has a convenient chart explaining when antibiotics are indicated. It is a good reference tool when developing sick child exclusion policies.

Sick Child Exclusion Policy Advisory Group Report Summary: Practical considerations in implementation of model sick-child exclusion policy in childcare settings

Best Practices Group:

The Get Smart program is committed to offering recommendations based on best science on antibiotic resistance in the child care setting. The Best Practices Group includes childcare and child health experts committed to providing advice to child care providers, directors, or parents about sick child exclusion policies. Sick child exclusion policies are used within child care centers to determine if a child should be excluded from care due to illness. Because recommendations for the development of sick-child exclusion policies have change in recent years, the Best Practices Group can help child care directors and providers construct the best policies for their center. Information and publications will be provided on this page. Check back regularly to stay up-to-date on the most current science on sick child exclusion policies and training opportunities.

If your childcare center has questions regarding sick-child exclusion policies or antibiotic resistance in general, the Best Practices Group can respond to your questions and concerns. They can provide expert opinions on your particular situation using current science to support their suggestions. Final decisions rest on the directors and staff involved. The group can be contacted at In all inquiries please include a telephone number, childcare center name, and location.

Members Include:

Sharon Meropol, MD, PhD
Assistant Professor of Pediatrics & Epidemiology & Biostatistics
Rainbow Babies and Children’s Hospital
Case Western Reserve University School of Medicine

Anne Dodds
Keystone STARS
Health & Safety Specialist
Pediatric First Aid Instructor
Early Childhood Playground Inspector

Constance Lydon
Associate Director, Penn Children’s Center
AA in ECE from Delaware County Community
BA in psychology for University of Penn
State Directors Credential

Nkuchia M’ikanatha, MPH, PhD
Pennsylvania Department of Health
Bureau of Epidemiology

Operational Plans:

Pre-Post intervention surveys to assess child care center directors’ exclusion policy practices and opinions about antibiotic use.

Implementation of a pilot hand washing educational training seminar.

  • Selected providers from child care facilities across PA will be trained at the Bureau of Laboratories on disease and outbreak prevention in a child care setting through hand washing during the Get Smart About Antibiotic Week
  • Emphasize the importance of good hand washing through teaching materials and lesson plans with PA state standards.
  • Hands-on training using Glo Germ™ powder to practice proper hand hygiene.
  • Distribution of Glo Germ™ kits, teaching resources including a DVD on hand hygiene and sneezing, a cartoon book Germs Make Me Sick for children, and also a copy of Peeper Has a Fever, a children’s book from Hippocratic Press, to all participants.
  • A webinar to include interventions for providers, modified to include PA specific policy and practice, to understand sick-child exclusion policies and recognize, prevent and manage infectious diseases in child care facilities. The webinar will include the latest recommendations and strategies from the American Academy of Pediatrics (AAP).