What Parents Need to Know About Antibiotics
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Antibiotics are a medical miracle, but before you make another trip to the pediatrician’s office, consider the advice of Brandon Chatani, M.D., a pediatric infectious disease specialist at the University of Miami Health System.
What is the crucial thing parents should understand about antibiotics?
I use the “5 Rights” as guidelines for antibiotics use:
- Right patient: Your pediatrician should understand the full context of the patient. If your child has an immune disorder, they may need a specific type of medicine. Others are allergic or too young to take antibiotics. The first “right” is the most difficult for a doctor to establish; it is also the most important.
- Right drug: To treat illnesses effectively, your pediatrician must know what bacteria is being treated and prescribe accordingly. If strep throat is suspected, for example, a test can determine the course of treatment.
- Right dose: How much will your child need to fight a particular bug?
- Right frequency: How often should your child take the medication for it to be effective?
- Right route: Should the medicine be delivered in a topical cream, oral medication, or by dropper to the ears or eyes?
How can I, as a parent, help my pediatrician?
Keep a visual or written reminder of antibiotics your child has taken. Many parents forget the names of medications. An easy way to keep track is by taking a picture of the medication package with your phone. Remember that just because your child’s classmates or siblings have a sinus infection, your child may not have the same condition, and their treatment plan may differ.
Should antibiotics be taken at the same time each day?
Whenever possible, stick to a dosing schedule – same dose, same time of day. Maintaining prescribed levels of medication in the blood helps fight the infection more effectively.
Should these medicines be taken with food?
Your pediatrician may recommend taking a specific drug with fatty foods to aid absorption. Depending on the antibiotic, your child may need to wait up to three hours after taking the medicine before consuming dairy products. And some antibiotics should not be taken with grapefruit juice. Ask your pediatrician or pharmacist or read the medication literature for instructions.
You said that age might determine the type of antibiotic used. Can you give an example?
Bactrim is used for many childhood ailments but should not be given to very young infants because it can cause low red blood counts and jaundice. This is very dangerous for their brains.
What side effects are associated with antibiotics?
Diarrhea and abdominal pain are the most common. There are also drug-specific aside effects like sun sensitivity with doxycycline. In the past few years, we have learned that antibiotics overuse may lead to asthma, irritable bowel syndrome, obesity, and juvenile arthritis. Parents can learn about potential side effects by reading the literature that comes with the medicine or speaking to their pediatrician or pharmacist. Some drugs list the most common side effects on the package.
What about antibiotic resistance?
One of the biggest dangers associated with antibiotics is that by killing the harmful microbes in our bodies, they also damage some of our healthy microbes. A healthy microbiome is essential to health. While antibiotics are tremendously useful in treating illnesses caused by bacteria, all bacteria carry a few strains with the potential to become drug-resistant. The Centers for Disease Control estimates that over two million Americans are affected by antibiotic resistance annually, and about 23,000 die from these “superbugs” each year.
What illnesses don’t respond to antibiotics?
Antibiotics are not effective in treating viral infections such as the common cold or bronchitis with a cough that doesn’t indicate a serious upper respiratory infection. Many parents think children need antibiotics when they have thick, opaque, or discolored nasal discharge. Again, if the infection is viral, antibiotics won’t work. Unfortunately, antibiotics are commonly over-prescribed for viral infections. Fungal infections such as ringworm also don’t respond to antibiotics.
When are antibiotics most helpful?
They are useful in treating strep throat, acute ear infections, and sinusitis. To make sure your child has strep throat, your pediatrician should do a throat culture before prescribing medicine. Ear infections are diagnosed in a physical exam. Sinusitis can be more difficult to detect, but if a physical exam isn’t sufficient, the doctor may culture a tissue sample from the nose or sinuses to see if a bacterial infection is present. In some cases, an imaging study, nasal endoscopy or allergy skin test may be needed.
If the doctor doesn’t prescribe medication, what can parents do to ease their child’s symptoms?
Ask your pediatrician what they recommend. For upper respiratory illnesses, there are several things you can try without resorting to antibiotics. For instance, raise the head of your child’s bed to help drain the sinuses and alleviate coughing while your child sleeps. Children’s Advil or Tylenol helps relieve aches and fever brought on by the flu. Herbal tea with a teaspoon of honey eases coughing and scratchy throats. And, of course, make sure your child gets plenty of rest and fluids.
What if the symptoms persist?
Before you leave the doctor’s office, ask your doctor for a contingency plan, and what symptoms you should watch for in the coming days. If your child doesn’t improve within one or two days, call your pediatrician or schedule a follow-up visit.
Q&A compiled by Nancy Moreland, contributing writer.