Updated: Dec 7, 2021
What you need to know about antibiotics
Antibiotics have become such an integral part of modern day medicine. So much so that most people are so familiar with them that they have begun to view them as "no big deal". But what should we really know about them to be well informed for our children's health? Unfortunately, because of their large role in healthcare we have come to realize that sometimes they aren't being utilized appropriately, which leads to the need for U.S. Antibiotic Awareness week, which is the week of November 18-24, 2021. So why not use this as a time to continue to raise awareness.
Antibiotics are utilized to treat bacterial illnesses. They serve no purpose in treating viral infections. Viral illnesses resolve on their own, commonly in approximately 1-2 weeks. Let's talk about some common respiratory illnesses and whether or not they are bacterial, viral or both bacterial AND viral, and whether or not antibiotics are necessary.
Bacterial illnesses needing antibiotics: strep throat and pertussis
Viral illnesses NOT needing antibiotics: common cold/runny nose, influenza, COVID-19
Either bacterial or viral illness and NOT needing antibiotics: bronchitis (otherwise healthy individuals)
Either bacterial or viral illnesses and MAYBE needing antibiotics: sinus infection and inner ear infections
Important things to note: Bronchitis does not need an antibiotic and research has shown that antibiotics do not make you feel better if you are an otherwise healthy individual. Also, some sinus infections and inner ear infections are viral and do not require an antibiotic.
Antibiotics are the most commonly prescribed drug class for kids
About half of all antibiotics prescribed for children are unnecessary
44 % of children with colds were given an antibiotic
46 % of children with upper respiratory infections were given an antibiotic
75% of children with bronchitis were given an antibiotic
This really highlights the importance of raising awareness about appropriate antibiotic usage.
There are some beliefs regarding antibiotics that we have come to know as the truth that are actually false and I believe are an integral part of our unnecessary use of antibiotics in our society.
My child has a fever, they must need an antibiotic. Viral illnesses often cause fevers as well. They may or may not need an antibiotic.
Their boogers are green, they must need an antibiotic. The fact that the boogers are colored does not indicate that this is a bacterial illness requiring antibiotics. Most of the time this is still a viral infection that will resolve on its own but if it is persisting then it may be a good time to see your doctor.
I (parent or other family member) was prescribed an antibiotic so this child must need one too! Remember half of antibiotics prescribed for children are unnecessary.
This illness has lasted more than a couple days so they must need an antibiotic. Viruses often last anywhere from 7-10 days and sometimes longer. If you have concerns you should reach out to your childs provider for evaluation.
Consequences of inappropriate antibiotic use.
There are three main consequences to inappropriate antibiotic use. The first one being the most important which is antibiotic resistance. In short, antibiotic resistance means that the antibiotic we would normally use to treat xyz illness is resistant to this antibiotic (it doesn't cure it). This often limits our choices and causes us to use something stronger that often has more side effects. This is a lifelong problem, not just one that will be present during childhood. The next consequence is the potential for c.difficile infection. This is an opportunistic bacterial infection that often arises from frequent antibiotic use and comes with very nasty GI symptoms and is difficult to treat. The last thing is the potential for unnecessary allergic or other types of antibiotic reactions.
A few things to keep in mind
Viruses often resolve on their own within that 1 -2 week timeframe. If we are prescribed an antibiotic unnecessarily for a viral illness, we mistakingly think that the antibiotic is helping our symptoms, when actually it is just the normal progression of symptom resolution. This explains why most people think that they feel better when they get antibiotic for bronchitis, but actually the infection is just going away on its own in the time it typically takes. This does make this very confusing.
Many viral illnesses have rashes that accompany them at one point during the illness, whether it be beginning, middle or end. Unfortunately, if your child is prescribed an antibiotic when it is actually a viral illness and they develop this rash, it can become very confusing. We often times assume that this rash is related to an antibiotic allergy or reaction rather than coming from the viral infection. This adds unnecessary allergies to our allergy list, which then limits our use of this antibiotic for future. A common example of this is with amoxicillin, which you hear as a frequent antibiotic allergy.
Important ways that you can help to combat this problem
Try not to ask your childs' provider for an antibiotic. Instead, try wording it as "do you think that this requires an antibiotic?"
Ask for a follow up plan. When should you be bringing them back in to be seen? What symptoms should you be monitoring for?
Take antibiotics as prescribed. Finish full course of treatment, even if your child is feeling better.
Don't take antibiotics that aren't yours, that are from another illness, or are expired. Most medications for children are dosed based on their weight. If it is from a previous illness or for another child/adult then it likely is not the adequate dose to treat the infection or could be too much.
What can you do to help your child feel better when it is a viral illness?
Management of viral illnesses is all about supportive care. Encouraging fluids and bottles is step number one. Suctioning out their secretions will aid in them breathing easier and give them more interest in eating and drinking. Utilizing a humidifier and steam filled bathroom will help to loosen stubborn nasal secretions. Over the counter medications serve their purpose as well, but make sure to check the label for age specific instructions.
Antibiotics definitely serve their purpose and there is a time and a place for utilizing them. The goal is not to scare you with this information, but rather to educate you and empower you to think twice when your child is prescribed an antibiotic or you are thinking that they may need one.
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