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Does my child need Antibiotics?

April 13, 2012

Does My Child Need Antibiotics?

About once a month, I will get a phone call from any one of my girlfriends who is looking for a friendly “second opinion” about their child. She tells me that her child hasn’t been feeling well for a few days, and she finally got an appointment to see their pediatrician on short notice. She becomes disappointed because her doctor did not give her a prescription for antibiotics for her child. She is upset because her child “always gets better on antibiotics.” My friend voices her frustration because she feels like her doctor “didn’t do anything.” Then she may ask me to “just prescribe something” for her child. I gently have to tell her no, because it is not right for me to do that since her child is not my patient, and I have not examined her child. I reassure her to trust her pediatrician, and to definitely keep her doctor in the loop if her child’s condition is not improving, or actually worsens over the next day or two.

What are Antibiotics?

Antibiotics are medications that can be used to treat bacterial infections. For example, if your child has an ear infection or strep throat, your pediatrician will prescribe an appropriate antibiotic to help treat the infection. Anti-virals are medications that can treat viral infections, such as influenza or herpes simplex. Anti-fungals work against fungal infections, such as ringworm or yeast infections.

It’s important to understand that your child may not need antibiotics every time he or she is sick. Many mild viral infections, such as the ones that cause the common cold, resolve on their own and do not require antibiotic treatment. In some cases if antibiotics are prescribed when not truly necessary, then a parent may think that the antibiotic helped, but it was actually the natural progression of a viral illness that was going away. The important thing to remember is that you should always contact to your child’s pediatrician or family physician when your child is not feeling well. Your physician will perform a history and physical examination, and then determine if your child will get better with antibiotics or not.

When Should We Use Antibiotics?

Antibiotics are fantastic when used appropriately to treat bacterial infections. Antibiotics will not help if your child has an infection from a virus. There are some viruses that we can test for (such as RSV or influenza), but hundreds of viruses that we do not have tests for. Typically, the best treatment for a viral infection is lots of rest, hydration with fluids, and fever control when needed. If your child is diagnosed with influenza infection, some children may benefit from an anti-viral medication to help shorten the course and symptoms of influenza infection. However, it’s important to remember that most healthy children do not receive nor require anti-viral medication for mild viral illnesses. Any time your child is feeling sick, your child’s physician will be the best person to help guide you with a plan.

Can Antibiotics Be Harmful?

Sometimes antibiotics are unnecessary, and may actually cause harm. We only want to use antibiotics if they are necessary, because there is a chance that antibiotic-resistant bacteria may develop in your child if they get repeated exposures to antibiotics when not necessary. The antibiotic-resistant bacteria can be more difficult to treat in the future. Repeated use and inappropriate use of antibiotics are some of the main causes of the increase in resistant bacteria that we have seen. Some antibiotics also have side effects such as diarrhea or abdominal discomfort. Repeated antibiotic use is associated with diarrheal illness, such as Clostridium difficile (also known as C. diff).

Safety Tips for Using Antibiotics

If your child’s physician does prescribe an antibiotic, please use the antibiotic for as long as it has been prescribed. Your child will probably feel better after a few days of starting antibiotic treatment, but don’t stop giving the antibiotics yet! If you stop the antibiotics too early, there is a chance that the infection could return. When your child finishes the course of antibiotics as prescribed, there may be some remaining antibiotics and please remember to throw the remaining doses away. Out-of-date medications may not be useful and can actually be harmful. Also, don’t use one child’s antibiotic for a sibling or a friend because it may not be the appropriate medication or dose, and you may cause harm.

Antibiotics should be used wisely, appropriately, and as directed by your child’s pediatrician or family physician. If we follow these guidelines for using antibiotics appropriately, then we will be able to help preserve life-saving antibiotics for our children and the future.