Your child has a runny nose, a cough, a sore throat, and a fever, so you go to the pediatrician. The doctor knows a virus caused this infection, which will just run its course. You're worried, so you push the doctor to give your child an antibiotic. The doctor gives in.
Who's wrong? Both you and the doctor, experts say. Children have the highest rates of antibiotic use and they also have the highest rate of infections caused by antibiotic-resistant pathogens, but antibiotics are not necessary for the majority of infections seen in the pediatrician's office. Parent pressure can influence a doctor's decision about using antibiotics. Doctors prescribe antibiotics much more often for children if they think parents expect them, but less often if they feel parents do not expect them.
Overuse of an antibiotic can help breed strains of bacteria that the drug won't kill. This antibiotic resistance can make a powerful drug useless. If your child becomes ill with bacteria that are resistant to the antibiotic prescribed, it's likely the illness will last longer than it should. You may end up having to get a different prescription to fight the illness. More serious infections might lead to a stay in the hospital to combat the illness. Some infections may be fatal. Also, your child may pass on resistant bacteria to other family members and friends, spreading the problem.
When an illness does require antibiotic treatment, it's important that your child take the medication exactly as prescribed by your pediatrician. Don't stop having your child take the medication because he or she starts to feel better. Just as overuse of antibiotics leads to resistant bacteria, so does using only a partial dose. Each time antibiotics are taken, sensitive bacteria are killed, but resistant ones may be left to grow and multiply, according to the CDC.
Most of the infections pediatricians see in the office are viral. Viruses cause colds, for instance, and symptoms can last five to 10 days.
Antibiotics also can cause various side effects, such as stomach upset, abdominal cramps, and diarrhea.
So how do you know when your child needs an antibiotic? Leave that to the doctor, but don't bite your tongue—ask if it's needed, and if not, why? If you have questions or you're not sure, call the pediatrician or make an appointment.
Your child's doctor uses a physical examination and evaluation of symptoms to determine whether to prescribe an antibiotic. For an illness such as sore throat, the doctor can take a throat culture to see if strep bacteria are present and then treat appropriately. If the doctor suspects that an infection is caused by bacteria, he or she may prescribe a broad-spectrum antibiotic that can fight a range of bacteria.
The CDC offers this list of common illnesses and whether they can be treated with antibiotics:
Ear infections. These come in several types. Many ear infections need antibiotics, but some do not.
Sinus infections. Most children with thick or green mucus do not have a sinus infection, but they may have a secondary infection of the nasal passages. For long-lasting or severe cases, antibiotics may be needed.
Cough or bronchitis. Children rarely need antibiotics for bronchitis.
Sore throat. Most sore throats are caused by viruses. Strep throat is the only common throat infection that requires antibiotics. This illness must be diagnosed by a laboratory test.
Colds. Colds are caused by viruses and sometimes may last for two or more weeks. Antibiotics have no effect on colds. It is normal for mucus to thicken and change color during the course of a cold. This change does not mean the child has a bacterial infection.