Returning After Starting Antibiotics

[Jedrnurse, BSN, RN]

The "classic" rule of thumb for students starting antibiotics was that they should be on them for at least 24 hrs prior to returning to school. Lately, I've been seeing 12 hours as the minimum. 

What are people doing in their various schools? 

Thanks!

[Flare, ASN, BSN]

we're still 24 hr

[LikeTheDeadSea, MSN, RN]

24hr or note from doctor clearing them to return sooner.

[MHDNURSE]

Interesting you posted this as we have always gone by the 24 hour rule (plus fever-free) and just a couple weeks ago my friend's daughter was Dx'd with strep and her MD wrote a note to return 12 hours after antibiotics.  This is definitely a new trend.  All the data I am finding is still saying 24 hours so I am not sure what the local peds folks are reading to suddenly change from 24 to 12, but it is definitely a trend.

[OyWithThePoodles, RN]

Back when I was seeing a lot of strep, MD's were starting to write to return after 12 hours. I was surprised honestly.

[JenTheSchoolRN, BSN, RN]

1 hour ago, MHDNURSE said:

Interesting you posted this as we have always gone by the 24 hour rule (plus fever-free) and just a couple weeks ago my friend's daughter was Dx'd with strep and her MD wrote a note to return 12 hours after antibiotics.  This is definitely a new trend.  All the data I am finding is still saying 24 hours so I am not sure what the local peds folks are reading to suddenly change from 24 to 12, but it is definitely a trend.

So kid can return the next day, I think. Because office visit at say, 11 AM. Antibiotics picked up at ~1 PM after. Means kid can return the next day vs the day after.

Not saying I agree with this, just pointing it out. I tell families kid still needs to be fever free without the use of meds for at least 24 hours.

[Eleven011]

We have the 24 hour rule also, but If asked I always say if they can get a full days worth of antibiotics in, they can come back the next day.  So if they have a 9am appointment, get started right away and get their full daily course in, they can return the next day.  But if 4pm appointment, meds started with supper, no return the next day.  

[LikeTheDeadSea, MSN, RN]

Went on a search  because I was thinking about this all morning, LOL

CDC lists 12 hrs:
https://www.CDC.gov/dotw/strepthroat/index.html

https://www.CDC.gov/groupastrep/diseases-hcp/strep-throat.html

References include the 2018 Red Book, published by American Academy of Pediatrics which is where they publish their Infectious Diseases recommendations.

[Jedrnurse, BSN, RN]

23 hours ago, LikeTheDeadSea said:

Went on a search  because I was thinking about this all morning, LOL

CDC lists 12 hrs:
https://www.CDC.gov/dotw/strepthroat/index.html

https://www.CDC.gov/groupastrep/diseases-hcp/strep-throat.html

References include the 2018 Red Book, published by American Academy of Pediatrics which is where they publish their Infectious Diseases recommendations.

How in the world did you shift gears from all-things-COVID to another clinical concept?

[k1p1ssk, BSN, RN]

On 11/24/2021 at 11:21 AM, Jedrnurse said:

How in the world did you shift gears from all-things-COVID to another clinical concept?

I'd imagine any opportunity to NOT talk about COVID is welcome... It is for me!

[CommunityRNBSN, BSN, RN]

On 11/23/2021 at 10:08 AM, JenTheSchoolRN said:

So kid can return the next day, I think. Because office visit at say, 11 AM. Antibiotics picked up at ~1 PM after. Means kid can return the next day vs the day after.

Not saying I agree with this, just pointing it out. I tell families kid still needs to be fever free without the use of meds for at least 24 hours.

I agree that this is the reasoning.  The 24-hour thing for vomiting (I realize that's a separate issue) has always bothered me.  Because I've seen cases where a child vomits at school at 9am, they are sent home, and are absolutely fine for the entire rest of the day and they sleep well. But they aren't supposed to send them to school the following day, because school starts at 8am. 

[NutmeggeRN, BSN]

8 minutes ago, CommunityRNBSN said:

I agree that this is the reasoning.  The 24-hour thing for vomiting (I realize that's a separate issue) has always bothered me.  Because I've seen cases where a child vomits at school at 9am, they are sent home, and are absolutely fine for the entire rest of the day and they sleep well. But they aren't supposed to send them to school the following day, because school starts at 8am. 

And it really depends on the reason for the vomiting...I don't send everyone home. Meds and no food, stress. menses etc...