TMH Living Well: Antibiotics aren’t always the best treatment for sick children
April 17, 2015
When your child is sick you want to do whatever you can to get them better — fast. You bundle them up and take them to the doctor, expecting to get something to get rid of the illness, but you end up with a list of ways to treat the symptoms instead.
If you leave wondering why you didn't get an antibiotic to fix the problem, you may need a quick lesson in what antibiotics are used for and what causes common illnesses — a virus or a bacteria. After all, antibiotics only work on bacteria.
Quick quiz: which illnesses are caused by bacteria and therefore require a trip to the doctor for an antibiotic? A cold? No. The flu? No. Stomach upset? Rarely. Ear infection? Maybe. Sinus infection? Maybe. Strep throat? Yes! It's really the only common illness that affects kids that requires an antibiotic every time.
The others? Likely your doctor will recommend keeping your child home with plenty of fluids and rest, unless it's been longer than two weeks without improvement.
"There's a general misconception that kids need antibiotics when they're sick. Antibiotics are the exception more than the rule," said Dr. Kelly Follett, pediatrician with The Memorial Hospital's Medical Clinic.
That's because viruses cause many common illnesses and there is no cure for viral infections like there is for bacterial infections. Yes, there is flu prevention medicine such as Tamiflu but it doesn't stop the flu in its tracks, rather it can shorten how long it lasts and lessen the severity of symptoms, if taken within 48 hours.
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"Even ear infections can be viral and depending on the circumstances, we take a wait and see approach. The same is true for sinus infections. It's usually when symptoms last more than 10 to 14 days that we worry it could be bacterial," Follett said.
Don't be too disappointed if you don't get an antibiotic for your child. There are good reasons to avoid them when you don't need them besides the fact that they won't work. The big reason is because the overuse of antibiotics has caused some bacteria to become resistant to common antibiotics, making them ineffective.
"Bacteria becomes resistant to antibiotics over time, not only for the people who overtake them, but for the community as well. MRSA is a good example. It's a serious staph infection that has become resistant to several common antibiotics. If people are infected with resistant bacteria, they may have a difficult time fighting their infection and may even require an IV antibiotic," Follett said.
In other words, if you use antibiotics when you don't need them, they might not work when you do.
Another reason to avoid antibiotics is because they not only kill dangerous bacteria, but also the helpful bacteria in our bodies. The human gut is full of bacteria that play an essential role in the immune system.
"That's why diarrhea is often a side effect to antibiotics, because it's killing the good bacteria in the gut," Follett added.
So if you leave your child's doctor appointment without a prescription, don't be too disappointed. Trust that you are getting the treatment you need.
"With most colds and the flu we recommend supportive care including increasing fluids, plenty of rest, suctioning out noses of little ones, running a humidifier and giving acetaminophen to ease a headache or body aches. Many over-the-counter cold medicines are not approved for kids younger than four," she said.
Follett also recommends holding off on treating a fever unless the child is uncomfortable. A fever is technically defined as 100.4 or higher. Doctors are concerned about fevers in kids under three months, and fevers that last over four days.
"Parents can get concerned and want to treat a fever right away, but it's your body's normal way of fighting an infection. I tell parents to judge more by how a child is acting with the fever rather than on how high their temperature runs. If a child is acting fine, then I don't recommend treating a fever," Follett concluded.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig — improving the quality of life for the communities we serve through patient-centered healthcare and service excellence.