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Tuesday, September 27, 2022

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Antibiotics: When do We REALLY Need Them?

Antibiotics are a major tool in treating illnesses caused by bacteria, but like any tool, they should be used appropriately. If they are not, the tool may not work when we really need it. The Centers for Disease Control and Prevention report that at least one-third of pediatric antibiotic prescriptions are unnecessary. David Berman, D.O., FAAP, FPIDS, a pediatric infectious disease specialist at Johns Hopkins All Children’s, explains when we do, and do not, need antibiotics just in time for U.S. Antibiotic Awareness Week, Nov. 18-24.

When do we need antibiotics?

Antibiotics are for bacterial infections only. This includes infections such as a bloodstream infections, skin abscess/impetigo, bacterial pneumonia, urinary tract infections, streptococcal pharyngitis and some middle ear infections. Certain antibiotics should be used very infrequently in children, such as azithromycin, commonly known as the “Z-Pak,” so it’s important to ask your child’s doctor what is truly necessary for their bacterial infection.

When should we NOT use antibiotics?

Colds, sore throats, upper respiratory infections and influenza (the flu) are caused by viruses, which antibiotics won’t kill, prevent or stop spreading. The only treatment for a cold is rest and time. While your child may not feel their best, it’s important to remember that within 10-14 days, symptoms will likely improve and there’s no need to take an antibiotic. 

This chart from the Center for Disease Control and Prevention breaks down exactly when you may need an antibiotic: 



Reactions and side effects of improper use

Research shows that about 70,000 kids visit the emergency center each year due to reactions from antibiotics. When inappropriately prescribed, adverse events can occur like diarrhea and liver and kidney injuries. Antibiotics can interact with other medications you might be taking and allergic reactions can also occur which are sometimes life-threatening, resulting in emergency room visits.  

Are there risks to taking antibiotics even when needed?

Even when taken appropriately, antibiotic adverse events are still possible, so parents should monitor their children closely and ask their health care provider questions like, “Does my child absolutely need this” and “Is this the right antibiotic?”

Additionally, 90% of patients who report a penicillin allergy are not truly allergic and can receive penicillin or similar antibiotics safely. A rash during a childhood viral illness or gastrointestinal side-effects from an antibiotic may have been called an allergy. Unfortunately, once someone is labeled in their record as having a penicillin allergy, it is difficult to remove that label. This results in prescribing broader-spectrum, more expensive and less safe antibiotics. Talk to your child’s provider in-depth about these concerns before they officially mark down a penicillin allergy.

Always remember, antibiotics do not treat viruses, so never ask your doctor to prescribe you an antibiotic for a virus.

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