|Vol. 21, No. 18||October 1, 1999|
Antibiotics: When Are They Necessary?
Your child is sick with a slight fever, strong cough, and discolored mucous. Does he need an antibiotic? Your doctor can tell you for sure, but chances are good that he does not. As a matter of fact, because many children are given antibiotics unnecessarily, a major problem is spreading across Texas.
The physicians of Texas Medical Association urge you to learn more about antibiotics so that you can better determine when they are needed.
"Antibiotics are overused most among young children," says Dr. Kate Hendricks, Austin division director for Infectious Disease Epidemiology and Surveillance at Texas Department of Health. "Because of this, strains of bacteria are created that are `resistant' to antibiotics. This happens a lot in daycare facilities or other places where groups of children are together often. Let me explain: As all parents know, kids are not what you would call `sterile.' A child always has some bacteria on his skin, in his nose and throat, and in his gut. A small number of these bacteria might be considered `bad,' and they are usually kept in check by the immune system. However, most of these bacteria are harmless and some (like the ones in your gut) are even what you would call `good.'"
"Now say a child is put on antibiotics for a good reason like an inner ear infection, or a poor reason like a cold. While the antibiotics are killing the bad bacteria, they are also killing some of the harmless or good bacteria. Once a child stops or finishes a course of antibiotics, the bad or good bacteria that are left will likely be resistant to the antibiotic that was just used. Now if these resistant bacteria somehow get past a child's normal protective barriers - like through a scratch on the skin - they can cause illness that is pretty hard to treat."
"Parents need to realize that every time a child takes an antibiotic, they have increased their risk of later developing a resistant infection. They also have an increased risk of passing on resistant bacteria to other kids. So it's really important to only take them when it is absolutely necessary - like for a strep throat or an inner ear infection."
Dr. Hendricks goes on to explain that it's important for parents to understand when an illness is bacterial and when it's viral, and how to treat each one. She stresses that antibiotics are needed to cure illnesses caused by bacteria; however, antibiotics do nothing to help kill illnesses caused by a virus. Viruses cause most colds, coughs, and runny noses. You should treat the symptoms (such as a slight fever, cough or congestion) with plenty of fluids and over-the-counter medication and wait. Illnesses caused by viruses will go away on their own.
"Many people assume that antibiotics are needed to cure most illnesses, but this is not the case. Parents want so badly for their sick children to feel better, that they are often quick to ask for or insist on antibiotics when their children are ill," says Dr. Hendricks. "Many parents don't know, for example, that discolored mucous is not a sign of a bacterial infection. It's normal for mucous to be clear at the beginning of a cold, then discolored, then clear. A common cold (and the discolored mucous associated with it) will go away on its own."
Your doctor can tell you if your child will need an antibiotic or not. Often you can speak with your doctor or a nurse over the phone to discuss the likelihood of a bacterial infection versus a virus. He or she can tell you if you need to make an appointment for your child and if antibiotics may be necessary. Your doctor can discuss your child's specific case with you, but in general:
When you or someone else in your family is prescribed an antibiotic, make sure the medication is taken exactly as directed, and completely finished. Symptoms often disappear within a few days; however, continue the prescription to kill off all the bad bacteria. Otherwise only the weakest bacteria will be killed, leaving behind the stronger, more resistant bacteria. Also, never share antibiotics. Throw away any leftover medicine as soon as you are finished with it.
- Texas Medical Association
©2006 Texas Medical Center