Overprescription of Antibiotics

Overprescription of Antibiotics

Several weeks ago, when my seven-year-old son came down with a nasty cold and cough, I thought for sure the pediatrician would prescribe antibiotics. But instead, she sent us home empty-handed. "Chances are it's just a bad virus that needs to run its course," the doctor explained. "If I give him an antibiotic for no reason, this same antibiotic might not work in the future when he really needs it."

Drug-resistant bacteria

Like many pediatricians, my doctor is alarmed by the steady rise in infections that don't respond to antibiotic treatment. To help slow the problem, she and other physicians want to limit the inappropriate use of these medications.

Antibiotics remain the treatment of choice against bacterial infections like staph and strep; but they're simply useless against the vast range of viruses that cause most of the colds, coughs, vomiting, diarrhea, and a majority of sore throats in children. In fact, if an antibiotic is prescribed for a virus, explains Dr. Stegelman, medical director of urgent care services at Egleston Children's Hospital in Atlanta, the drug won't alleviate any of your child's symptoms and may even cause significant side effects like diarrhea, nausea, vomiting, or a rash.

"Wrongly prescribed, antibiotics can kill off weaker bacteria that naturally live in the body," says Dr. Stegelman, "allowing the stronger ones to survive and later transfer their resistant genes to other, more dangerous bacteria. This could make future treatment of bacterial infections more difficult, even potentially fatal."

Not every symptom needs treatment

Along with limiting antibiotics, doctors also are trying to clear up some of the misconceptions about childhood illnesses. "In most cases, green or yellow running nose is just a normal part of having a viral cold and should not be treated with antibiotics," says Richard Schwartz, MD, clinical professor of pediatrics at Georgetown University in Washington, DC.

"Granted, it won't be easy for parents to deal with these longer-lasting illnesses, especially when they factor in the time and cost of repeated doctor's visits," notes Stan Block, MD, assistant clinical professor of pediatrics at the University of Louisville. "But unless your child is under six months, has a high fever or trouble breathing, we usually advise parents to wait and let the illness declare itself."

Experts also advise a go-slow approach to ear infections. Recent data shows that 80 percent of acute ear infections (without fluid buildup) clear up by themselves in two or three days without any treatment. "Unless I see an eardrum that's bulging, bright red, and clearly infected, I won't prescribe," says S. Michael Marcy, MD, staff pediatrician at Kaiser Foundation Hospital in Panorama City, California. "Often, it's best to let the body's own defenses fight off the virus."

What parents can do

No matter how rotten your child feels, don't expect or insist on an antibiotic if the doctor says the cause of the child's illness is viral. Instead, you can help protect your child and fight drug resistance by taking these basic steps:

• If your child seems ill, try acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) in appropriately recommended doses, and be observant for a day or two. However, if your child spikes a high fever, has drainage from the ear, or is not acting right in your eyes, you should consult his doctor.
• Don't borrow or use stockpiled medication -- taking leftover antibiotics can invalidate tests or disguise true symptoms of an illness, and that could leave your child with more serious complications as a result.
• If your doctor does prescribe an antibiotic, be sure to give each dose on time. Skipping a dose or getting off schedule could make an infection worse or lead to a relapse.
• Finish the seven to ten day course of medication exactly as instructed. The only time you should discontinue antibiotic therapy is when your child shows signs of an allergic reaction -- a rash, nausea, vomiting, breathing difficulties, or increased illness. If so, call your doctor immediately.
• If recommended, schedule a follow-up examination once your child has finished his medication to ensure he's fully recovered.