Please Just Give Me an Antibiotic

This is the time of year when thousands of frustrated parents flock to the emergency room in hopes to find the magic cure to end their child’s miserable symptoms. Anything to end the many sleepless nights due to a horrible night time cough. Something to stop the mid-day telephone calls, asking to have their child picked up from school because they will not stop coughing. For many, I am the third doctor they have seen in the last three weeks. Their child has already finished a course of steroids, is taking albuterol, and nothing is working. All they want is for their child to start to feel better and for life to go back to normal.

After doing a thorough physical examination and performing chest radiographs, I am plagued with the job of informing them that the cough is most likely due to a virus and there is no magic medication that is going to resolve their child’s symptoms. Some parents are comforted in the fact that it is not anything serious. However, many feel completely defeated and beg me to put their child on an antibiotic.

As pediatricians, we always want our parents to leave the ER feeling comforted and that their child’s needs were addressed. Unfortunately, for many parents, they do not feel any sense of relief unless a medication is prescribed. The truth is that starting your child on an antibiotic when it is not warranted is not only ineffective but can also be dangerous. While antibiotics are essential if you’re dealing with a bacterial infection, the reality is that many childhood illnesses are caused by viruses that cannot be treated with antibiotics. So today we are going to go over the basics of when an antibiotic is helpful and how to prevent overuse.

Bacteria vs. Virus 

Bacteria are microorganisms that exist in both living hosts (us) and  in the environment, such as the water and soil.  There are “good” bacteria which our bodies need and “bad” bacteria that can cause infection in plants, humans, and other animals. The common infections caused by bacteria are strep throat, pneumonia, skin infections, and kidney infections. When a child is suffering from an illness caused by a bacteria, antibiotics are important in fighting off the infection.

A virus is a biological agent that is smaller than bacteria and needs a host such as people, plants or animals in order to multiply and survive. When a virus enters your body, it invades the cells in your body and takes over the cell’s normal function, forcing it to produce the virus.  Viruses such as influenza, hand foot and mouth disease, and rotavirus will not respond to antibiotics. Use of antibiotics in the case of a virus can cause side effects that can make your child feel even worse.

Is there any danger in trying an antibiotic to see if it helps my child’s symptoms?  YES! I get asked this question all the time and the answer is always YES! There are many side effects and complications associated with taking an antibiotic. When your child is battling an infection that is caused by bacteria, the danger of not treating the infection outweighs the risk of the side effects associated with taking the antibiotic. However, if your child is suffering from a virus, giving your child an antibiotic is putting him or her at an unnecessary risk. There are short term side effects such as diarrhea, rash, and allergies from taking antibiotics. There are also always risks for an autoimmune response, drug resistance, and altering the “good” bacteria that our body needs.

If it is a virus, why does my child always get better after taking an antibiotic? Most parents take their child to see the doctor three or four days into the virus. Many times your child is already towards the end of the course of the virus. So the simple answer is, it truly is a coincidence!

Can my child have a bacterial infection as well as a virus? Absolutely and that is why it is imperative that you have your child evaluated by a doctor when they are suffering from a fever.

How does a doctor determine whether an antibiotic is warranted? By evaluating a combination of the symptoms your child is having, physical examination findings, laboratory results, and of course experience and knowledge.

How do I prevent giving my child an antibiotic that isn’t necessary?  Be an active part of your child’s healthcare! If your child is prescribed an antibiotic, ask the provider what they are treating. Make sure that you understand what medications your son or daughter is taking and why they are taking it!

My child has been prescribed an antibiotic, is there anything I can do to prevent the side effects of antibiotics? Ask your doctor about taking a probiotic or “good bacteria” while your child takes antibiotics for a bacterial infection. There is some research that indicates that a probiotic such as Florastor may help to rebuild the healthy bacteria in your child’s body!

I hope this helps with your journey.  See you next Wednesday!