Returning After Starting Antibiotics

[Jedrnurse]

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!

[arlingtonnurse]

I had thought the 24 hour vomiting rule was pretty universal but my medical director told me no, if a student has kept down multiple meals she thinks they should be in school.  Had to change all our on line literature...

[KKEGS, MSN, RN]

We follow the infectious disease manual from a local county public health department.  They produce the fact sheets that we hand out to parents when there is a communicable disease in the classroom.  According to the strep fact sheet, which was updated in October 2018, students can return to school after being on their antibiotic for 12 hours and fever free.  It doesn't mention that they have to be fever free for 24 hours though but we still require them to be fever free for 24 hours without the use of medications to reduce fever. 

[JenTheSchoolRN, BSN, RN]

4 hours ago, NutmeggeRN said:

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

If I sent home every single vomiting kid for 24 hours...I'd be missing a lot of kids.

I have a LOT of anxiety pukers. Even more so this year. And even older than usual. 16 and 17 year olds anxiety pukers. Many get tested for COVID, all negative thus far. So I have a plan with some parents and the anxiety pukers puke and move on. 

[Jedrnurse, BSN, RN]

4 hours ago, NutmeggeRN said:

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

I agree. Sometimes it's a "one and done" and has nothing to do with a contagious reason.

[k1p1ssk, BSN, RN]

This year my chronic pukers have been kids with new-onset migraines - one gets the intense headache, vomits, and is fine; the other gets blurred vision, the beginnings of a headache, vomits and then gets a REALLY bad headache. I also have a motion sickness kiddo who has gone the longest he ever has without an incident this year *knocks on wood*

But yeah, not all pukes are created equal.