Health Break | Published November 21, 2005 | Written by Kristie L. Kaufman, MD

Antibiotics Are Not Always The Answer For Ailing Children

Has your sick child ever not been treated with an antibiotic after visiting the doctor? Hopefully, this is the case. Antibiotics can treat a variety of infections, however, these medications may not be the cure. In fact, they may cause harm to your child if used improperly. The necessity or non-necessity for antibiotics is exemplified especially during flu season.

Antibiotics are used to treat bacterial infections. They are not effective in treating a viral illness, as is the case with most childhood infections. Your health care provider will diagnose your child's illness and make the decision as to whether it is viral or bacterial. Antibiotics should be taken as directed for the time prescribed and any excess discarded. Do not use old antibiotics for any undiagnosed infection.

The common cold, bronchitis, cough and many sore throat infections are generally viral. In other words, antibiotics will not make a difference.

There is a common misconception among the public, however, that antibiotics are a cure-all. The national Centers for Disease Control and Prevention funded a survey of more than 10,000 adults regarding their thoughts about using antibiotics when they had a cold, and found the following:

  • Nearly half said that if their colds were bad enough for them to see a doctor, they expected the doctor to prescribe antibiotics.
  • About one out of three people said that when they had a cold, antibiotics helped them get better faster.
  • More than one in four people said that they thought they should take antibiotics to prevent more serious illnesses.
  • More than one in 10 people said they had taken an antibiotic in the past month.
  • Less than half the people did not know there are health risks associated with taking antibiotics.

In the first 10 days of illness, most children have sinus symptoms with a cold that can be mistaken for a bacterial infection. However, a true bacterial sinusitis usually cannot be diagnosed until after 10 days of unimproved thick, yellow nasal discharge, which at that time can safely be treated with antibiotics.

Potential ear infections should always be visualized by a health care provider to determine the presence of a bacterial infection versus clear fluid that is not infected. Studies have shown that up to two-thirds of ear infections will resolve without antibiotics.

Rapid culturing methods are available to determine if a sore throat is a strep infection that should be treated with antibiotics.

Also, fever is often present with a viral infection for up to three days and does not automatically infer a bacterial infection necessitating antibiotic treatment.

Improper use of antibiotics can cause the emergence of resistant bacteria. The antibiotic will kill the sensitive bacteria allowing resistant, more resilient bacteria to proliferate. Resistant bacteria can spread to family and community members. Due to its resistance, these infections may need to be treated with more intensive intravenous antibiotics. This, in turn, may also result in hospitalization, in addition to causing more severe infections.

In summary:

  • Most childhood illnesses cannot be treated and will not benefit from antibiotics.
  • Antibiotics are used to treat bacterial infections, not viruses.
  • Allow your health care provider to diagnose your child's infection and determine treatment.
  • Misuse of antibiotics may be harmful to your child and others in your community.

Kristie L. Kaufman, MD, is a board-certified physician specializing in pediatrics health care. She practices at Centre Medical and Surgical Associates and is a member of the medical staff at Mount Nittany Medical Center.

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