In my practice as a pediatrician, I see many children suffering from colds.
When their concerned parents bring them in for me to examine and provide
treatment, they often think that an antibiotic may be needed. But that’s
usually not the case. Instead of writing a prescription, I take the
opportunity to educate parents on an important health issue with
potentially grave consequences: antibiotic resistance.
When used appropriately, antibiotics are one of our most vital weapons for
fighting off harmful bacterial infections. Unfortunately, however, studies
have shown that almost 30 percent of antibiotics prescribed to children are
unnecessary.
Why is this a problem? Because every time we take an antibiotic, resistant
bacteria may be left to grow and multiply. The repeated use of antibiotics
can increase the number of drug-resistant bacteria. Then, the next time we do need an antibiotic, these drugs are less likely to help.
Antibiotic resistance is a real and growing public health concern.
According to the Centers for Disease Control and Prevention, more than 2
million people each year get sick with an antibiotic-resistant infection,
and about 23,000 die. After decades of over-prescribing antibiotics, we’re
now seeing the development of “superbugs” that just don’t respond to any of
the antibiotics in our arsenal.
And resistance isn’t the only problem. Antibiotics are not benign; they do
have side effects. As they are doing their job of killing “bad” bacteria,
they are also killing “good” bacteria. These good bacteria are an important
component of our normal body flora. We need them to aid in proper digestion
and even to help our brains grow. When antibiotics knock out healthy
bacteria, more harmful bacteria grow in their place.
You might also be surprised to learn that it’s not uncommon for children to
have adverse reactions to antibiotics – serious enough to send them to the
hospital. In fact, according to the CDC, antibiotics are the most common
cause of emergency department visits for adverse drug events in children
under 18 years of age.
As pediatricians, we take seriously our need to be good stewards when it
comes to antibiotic usage. As parents, you can help us in this important
mission. When a doctor does prescribe an antibiotic for your child, be sure
to complete the entire course of treatment, even if your little one seems
fully recovered after a few days. And never hold some medication back and
start treatment on your own the next time your child (or her sibling)
develops a similar illness.
Twenty years ago, many parents who came into my office felt like they
weren’t getting their “money’s worth” if they didn’t leave with a
prescription for an antibiotic. Now that we’re experiencing the fallout,
it’s important for today’s parents to be savvier. Don’t insist on an
antibiotic from your pediatrician if he or she advises against one: Some
studies have shown that doctors will succumb to such pressure, even when an
antibiotic isn’t warranted.
While it’s natural to want to relieve your child’s suffering, remember that
the vast majority of all infections are viral in nature, and antibiotics
are never effective for viral infections.
Here are some common viral infections in kids that often don’t
need an antibiotic:
-
Earaches: While the pain of an earache can make
children miserable, for those over 2 years of age and without a fever,
antibiotics are not recommended right away to treat many ear infections.
Instead, trust your pediatrician to determine whether your child needs an
antibiotic to improve or whether watchful waiting is a better option. -
The common cold: Cold symptoms – sneezing, stuffy
nose, sore throat, coughing, post-nasal drip, watery eyes, mild body aches
– typically peak within two to three days, though they can last up to two
weeks. Generally, rest and over-the-counter medicines to help with symptoms
like fever and coughing will get your child through the cold. Antibiotics
are never needed. -
Bronchitis: The hacking cough caused by swelling
airways and mucus can linger for weeks, as can accompanying soreness in the
chest, mild headaches, fatigue, a sore throat and body aches. Acute
bronchitis is almost never caused by bacteria and almost always gets better
on its own. (If your pediatrician thinks your child is suffering from
asthmatic bronchitis, then follow his or her recommendations for
treatment.) -
Sinusitis: Sinus infections occur when fluid gets
blocked or trapped in the sinuses, allowing germs to grow. In children,
between 50 to 70 percent of sinus infections are caused by viruses, not
bacteria. So the odds are good that your child will not need an antibiotic
to effectively treat sinusitis. Your pediatrician can make the call. -
Sore Throat: Most sore throats with an associated
cold are caused by viruses and will go away on their own without any
antibiotic treatment. The exception is strep throat – caused by bacteria
such as group A Streptococcus. If your child has a sore throat and
a fever but no cold symptoms, a strep test is often called for. Your
pediatrician can perform this test by doing a quick swab of the throat and
then culturing it for bacteria. If strep is diagnosed, an antibiotic will
be prescribed to prevent rheumatic fever.
I certainly don’t want to underplay the value that antibiotics hold in
treating illness. Before the antibiotic age, people routinely succumbed to
pneumonia and rheumatic fever. A cut or scratch could lead to blood
poisoning – and death.
As a pediatrician, I am ever grateful to have penicillin and other
antibiotics to use in healing my young patients. But to ensure that
antibiotics work when we need them, we must take steps now to stop the
improper and excessive use of these important drugs.
To find out more about bacteria, viruses and the proper use of antibiotics,
visit the CDC’s website: cdc.gov.
