I am sure most parents would have experienced having their child falling sick at least once. When your child is down with fever, running nose, cough and refusing to eat, it can be pretty stressful. Parents will expect a fast remedy which may include antibiotics when they bring their child to see the doctor.
Conventionally, we used to think that by prescribing antibiotics even though the child might not need it, it may work and even if it doesn’t, it won’t do any harm. However, we now know the dangers of prescribing antibiotics unnecessarily and many doctors now are being very careful when prescribing antibiotics.
Antibiotics are one of the most common classes of medications being prescribed to children. There’s no denying that antibiotics play important roles in saving countless children’s lives. However, overuse of antibiotics can cause antibiotic resistance which is a threat to public health. Antibiotic resistance happens when the bacteria develop an ability to prevent themselves from being killed by antibiotics that previously were able to kill them. Antibiotic resistant bacteria can be difficult or impossible to treat. According to the Centres for Disease Control and Prevention (CDC) report, each year, in the U.S, there’s an estimate of 2.8 million people infected with antibiotic resistant bacteria and causing more than 35,000 death as a result. In order to prevent antibiotic resistance from happening, we have to be more vigilant in prescribing antibiotics. We also need to bear in mind that antibiotics are not without side effects. After consuming antibiotics, children can experience diarrhoea and vomiting and even allergic reactions which can be life threatening.
Which illnesses do not require antibiotics?
Bacteria and viruses are two major types of infection that make people sick. Bacteria respond to antibiotics where bacteria are either killed or the reproduction is being stopped. On the other hand, viruses do not respond to antibiotics and thus prescribing antibiotics will not treat the disease but instead causes more harm.
- Common flu are usually caused by viruses and thus do not need antibiotics. Symptoms can take as long as 10 days before recovery. Your child can be down with fever and can even have yellowish or greenish nasal discharge. However, if your doctor suspects a bacterial cause of sinusitis then antibiotics may be prescribed.
- More than 80% of sore throats are caused by viruses. However if your child has streptococcal sore throat which is caused by streptococcal bacteria, antibiotics will need to be given.
- Coughs are also normally caused by viruses and would not require antibiotics. However if it progresses to lung infection that are caused by bacteria then the doctor will need to prescribe antibiotics.
- Ear infections will get better by itself even without any treatment in more than half of the cases. If your child is not in pain and still well, we can give some time and see if the infection clears up by itself.
There is a possibility of ‘secondary bacterial infection’ where the viral infection increases the susceptibility to bacterial infection. Parents must be wondering that since viral infection can turn bacterial, why can’t we take antibiotics first instead of waiting for the bacterial infection to occur. Well, not all viral infections are followed by bacterial infections. Thus treating viral infection with antibiotics to prevent bacterial infection is not recommended as such practice will cause the emergence of antibiotic resistance.
What can parents do?
- Do not expect or request to be given antibiotics each time you visit the doctor. Remember that most cough, cold and nasal congestion will get better by themselves. Antibiotics are not the answer to everything. You can ask the doctor instead for ways to ease symptoms that your child is experiencing.
- Watch and monitor your child’s condition. If the condition seems to be worsening with persistent fever after 3-5 days, do not hesitate to bring your child to see your pediatrician and get your child assessed.
- If your child really needs antibiotics, remember to complete the entire course of antibiotics even if your child feels better before the antibiotics are completed. If antibiotics are stopped early, the bacteria may not be completely eliminated and complications can occur as a result of that. Apart from that, the remaining bacteria that was not eliminated will continue to grow and might mutate to a new form that can be resistant to the future treatment.
- Do not give your child antibiotics that were prescribed for someone else’s infection.
- Do not keep leftover antibiotics to be used for future infection. See the doctor and get a new prescription if the need arises.
- If your child’s condition is not improving despite being given antibiotics, see your doctor again as the bacteria may be resistant to the antibiotic that was given.
- Prevention from getting sick is always the best. Make sure your child has a healthy and active lifestyle. Educate your child to wash their hands regularly and keep the surrounding environment clean. It is also very important to ensure that your child’s immunizations are up
to date.
Remember that antibiotics are not always the answer to infection. Inappropriate usage of antibiotics can cause harm. Whenever you have any doubts about your child’s condition or whether antibiotics are needed, do not hesitate to consult your paediatrician and discuss your child’s condition.
By Dr Livia Chow Huey Ling
Consultant Paediatrician & Neonatologist,
Pantai Hospital Ayer Keroh
