Every day, thousands of parents visit the pediatrician’s office to find relief for their child’s cold and flu symptoms, and many demand antibiotics.
Pediatrician Jennifer Pesce of BayCare Medical Group is among the many physicians who know that antibiotics don’t cure viral infections, and that their increased use can lead to serious side effects and drug-resistant bacteria.
“It’s a big problem overall,” Dr. Pesce says. “But at least we are talking about it and making it an important issue. And as physicians, we need to try to not prescribe (antibiotics) as often as we do. We also need to educate parents about the need for antibiotics. Parents request (antibiotics) because they think their kids will get better faster. But that is not the case.”
Antibiotics, drugs that kill bacteria or stop them from reproducing, are effective only for bacterial infections, not viruses.
“Most of the time when kids come in with cold symptoms, there are other methods of treatment that will help, and the child’s own natural immune systems that will allow them to get better on their own without the use of antibiotics,” Dr. Pesce says. “Unless a physician is 100 percent sure of what’s going on, (antibiotics) shouldn’t be prescribed.”
Dr. Pesce encourages parents to know the facts about antibiotics.
The Centers for Disease Control and Prevention says antibiotics are one of the most prescribed drugs, but nearly half of the time, they are not needed. In fact, a recent study published in “Pediatrics” found that 11 million prescriptions for antibiotics were written for children every year that weren’t necessary.
Healthcare professionals say there are a variety of reasons for the excessive prescribing of antibiotics. In some cases, it can be difficult to distinguish between a viral or bacterial infection, so some physicians turn to antibiotics. Many times, parents insist on antibiotics because they feel they are necessary to help their child feel better.
However, parents need to understand that antibiotics will not cure all that ails their child. “Viruses cause colds, the flu, most sore throats, bronchitis and many sinus infections. A child’s own immune system can defeat a virus,” Dr. Pesce says.
And many times, over-the-counter medications can treat symptoms in children, along with rest and fluids.
The only time children need an antibiotic is when they are battling harmful bacteria, Dr. Pesce added. “Bacteria can cause illnesses like strep throat or a urinary tract infection,” she says. “In that case, an antibiotic can kill the living organisms.”
Ear infections are one of the most common reasons children see doctors and the leading reason kids get antibiotics.
Hoping to reduce unnecessary antibiotics use, the American Academy of Pediatrics issued new guidelines for how doctors should diagnose and treat ear infections.
The first thing the new guidelines say is physicians should make sure the child really has an ear infection. The only way to know for sure is to take a close look at the eardrum and see if it is clearly bulging. But even kids who really do have ear infections don’t necessarily need antibiotics. The guidelines say doctors have the option of just watching children who don’t have intense pain, a high fever or other symptoms of a severe infection.
But there are some children who definitely should get antibiotics, such as those ages 6 months to 2 years who have infections in both ears, or any child who has severe symptoms, such as severe pain for several days and a fever of at least 102.2 degrees. Any child who has a ruptured eardrum should also get antibiotics, according to the guidelines.
The new guidelines also recommend ways parents can protect their kids from ear infections in the first place, such as by breast-feeding and keeping kids away from cigarette smoke.
It is also important that a doctor prescribe the lowest dose antibiotic that will be effective to keep it from developing resistance to the drug.
“The bacteria that do survive the antibiotic get tough, and next time you get an infection, it’s going to be harder to manage,” Dr. Pesce says.
Children also can suffer side effects from being prescribed antibiotics unnecessarily, such as upset stomachs, diarrhea and allergic reactions.
Dr. Pesce says it’s important pediatricians examine patients very carefully and get a detailed history of the child from the parent, including how long the symptoms have been present to insure the right course of treatment is taken, including the right antibiotic if necessary.
While antibiotics are an incredibly powerful tool in the right circumstances, too many or the wrong kinds can cause problems. Overusing antibiotics leads to “antibiotic resistance.” That means the drug stops working on certain bacteria. The CDC estimates that 23,000 people die in the U.S. every year because of antibiotic resistance: There is no longer a drug that can effectively fight off the bacteria growing in their body.
The problem has become so prevalent, even the White House recently issued an executive order targeting antibiotic resistance, which included efforts to limit when a child takes antibiotics.
“Really, the most important thing is to have an open dialogue with your child’s pediatrician,” says Dr. Pesce. “The pediatrician has to be able to tell the parent why they are or are not prescribing antibiotics, and the parent needs to have the opportunity to ask questions about the plan of treatment for their child.”
Use antibiotics wisely
Antibiotics do not fight infections caused by viruses like colds, flu, most sore throats, bronchitis, and many sinus and ear infections. Instead, symptom relief might be the best treatment option for viral infections. Get smart about when antibiotics are needed—to fight bacterial infections. When you use antibiotics appropriately, you do the best for your health, your family’s health, and the health of those around you.
Taking antibiotics for viral infections, such as colds, flu, most sore throats, bronchitis, and many sinus or ear infections:
- Will not cure the infection.
- Will not keep other people from getting sick.
- Will not help you or your child feel better.
- May cause unnecessary and harmful side effects.
- May contribute to antibiotic resistance, which is when bacteria are able to resist the effects of an antibiotic and continue to cause harm.
Rest, fluids, and over-the-counter products may be your or your child’s best treatment option against viral infections.
What to Do
Just because your healthcare professional doesn’t give you an antibiotic doesn’t mean you aren’t sick. Talk with your healthcare professional about the best treatment for your child’s illness. To feel better when your child has a viral infection:
- Ask your healthcare professional about over-the-counter treatment options that may help reduce symptoms.
- Make sure your child drinks more fluids.
- Get plenty of rest.
- Use a cool-mist vaporizer or saline nasal spray to relieve congestion.
- Soothe your throat with crushed ice, sore throat spray or lozenges. (Do not give lozenges to young children.)
- If you are diagnosed with the flu, prescription flu antiviral drugs can be used to treat flu illness.
What Not to Do
- Do not demand antibiotics for your child when your healthcare professional says they are not needed.
- Do not give your child an antibiotic for a viral infection.
- Do not give your child antibiotics prescribed for someone else. The antibiotic may not be right for their illness. Taking the wrong medicine may delay correct treatment and allow bacteria to grow.
If your healthcare professional prescribes an antibiotic for a bacterial infection:
- Do not skip doses.
- Do not stop taking the antibiotics early unless your healthcare professional tells you to do so.
- Do not save any of the antibiotics for the next time you or your child gets sick.