Antibiotics: Preventing Unnecessary Use
Antibiotics are strong medicines that can kill bacteria.
Antibiotics have saved many lives and prevented many serious
complications. However, antibiotics have no impact on viral
infections. One of the more important decisions made daily
by every health care provider is whether a child's infection
is viral or bacterial. Parents can learn to make some of
these decisions themselves.
Viral Infections
Viruses cause most infections in children including:
Bacterial Infections
Bacterial infections are much less common than viral
infections. Bacteria cause:
Most ear infections
Most sinus infections
10% of sore throats (Strep throat)
Whooping cough (pertussis)
Some pneumonia (lung infection).
Common Myths about Symptoms
These symptoms are sometimes misused as signs of a bacterial
infection:
Yellow nasal discharge. Yellow discharge is more likely
to be a normal part of the recovery from a cold than a
clue to a sinus infection.
Yellow phlegm (sputum). This is a normal part of a viral
tracheitis or bronchitis, not necessarily a sign of
pneumonia.
High fevers. A fever can be caused by a virus or
bacteria.
Reasons Not to Overuse Antibiotics
Some people think that children with colds need antibiotics
to prevent ear or sinus infections. Following a cold, about
10% of children will develop an ear infection and 1% will
develop a sinus infection. Giving antibiotics to the other
89% who don't need them can cause the bacteria to become
more resistant and your child to have unnecessary side
effects. It is better to wait and give antibiotics to
children who really have a bacterial infection.
Bacterial Resistance
When bacteria become resistant to an antibiotic, that
medicine can no longer kill that type of bacteria. The more
antibiotics that are used, the more bacteria become more
resistant to the medicine. Research shows that half of the
prescriptions for antibiotics are not necessary. This makes
future treatment of bacterial infections more difficult.
Many bacteria are now resistant to antibiotics that used to
control them. When we turn to newer and more expensive
antibiotics, bacteria develop resistance to them as well. In
the battle between antibiotics and bacteria, the bacteria
seem to be winning.
Side Effects
All antibiotics have side effects. Unless your child really
needs an antibiotic, there is no reason to risk the side
effects of the medicine. Some children taking antibiotics
develop diarrhea, nausea, vomiting, or a rash. The
diarrhea is often caused because the antibiotic has caused
your child to lose some healthy intestinal bacteria. If your
child gets a rash, your provider must decide if the rash is
an allergic reaction to the drug or if it is an unrelated
viral rash (such as roseola). Because it's difficult to be
sure, your child may be considered allergic to a family of
antibiotics when he really isn't. Then your child can't
take that type of antibiotics again.
Summary
If your child has a viral illness, an antibiotic will not
shorten the course of the fever or help the other symptoms.
Antibiotics will not get your child back to school or you
back to work sooner. If your child develops side effects
from the antibiotic, he will feel worse instead of better.
Antibiotics should be used for ear infections, sinus
infections, Strep throat and other bacterial infections.
When your child has yellow nasal discharge, yellow phlegm,
high fevers and other normal symptoms associated with coughs
and colds, treat your child with over-the-counter medicines
or home remedies. Fortunately, the body's normal antibodies,
once produced, can kill future viruses. Call your health
care provider if your child develops any new signs that
suggest a bacterial illness.
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