Antibiotics and children
Antibiotics are one of the most often prescribed drugs for children's diseases. Their use has become so common that not much thought is given to their need for use, their side effects and precautions to be observed during the treatment.
In 2008, over 60 kinds of antibiotics are available for use in infants and children. Many more are in the process of being developed as research continues. It is estimated that 30 million courses of antibiotics are prescribed for children with ear infections alone in the United States each year.
During the first three decades of the twentieth century, when antibiotics were not available and common childhood bacterial infections often resulted in severe complications. Today, bacterial infections usually can be treated easily and successfully in children with access to good medical care.
Why should I be aware of this?
- Antibiotics are extremely important drugs and have a definite place in the majority of childhood infections.
- Antibiotics should only be given to children for bacterial infections such as middle ear infections, strep throat, and urinary tract infections.
- Do not give antibiotics indiscriminately to children for viral and non bacterial infections as it has adverse impact on their long term health.
All about antibiotics and children
Antibiotics are powerful and important medications used to for treating certain illnesses. When used properly they can save lives and avoid complications, but used improperly, they may actually harm the child.
Types of infections
There are two main types of germs that cause most of the infections.
- Bacteria -- Bacteria cause most ear infections , some sinus infections, strep throat and urinary tract infections. Most bacterial infections can be successfully treated with antibiotics.
- Viruses -- Viruses cause most coughs, most sore throats, all colds and all kinds of influenza. Antibiotics cannot cure viral infections. The child usually recovers from these common viral infections when the illness has run its course.
Guidelines For Antibiotic Use
Recognizing the urgent problem of antibiotic overuse, in 1998 the Centers for Disease Control and the Academy of Pediatrics issued guidelines for when to use (and when not to use) antibiotics for the most common pediatric respiratory infections
- Antibiotics should not be given for sore throats without a positive test for Strep or another bacterial infection.
- One of the penicillins (not the newer, broad-spectrum antibiotics) is the best choice unless the child is allergic to it.
- Regardless of how long it lasts, bronchitis or a nonspecific cough illness in children rarely warrants antibiotics.
- Antibiotics should not be given for the common cold.
- Most children should not be given antibiotics for a sinus infection unless there are both nasal discharge and cough without any improvement after more than 10 to 14 days.
- Children with severe symptoms (facial swelling, facial pain, a fever over 103) accompanying coughs may benefit from narrow-spectrum antibiotic.
- Not all ear infections are the same. Antibiotics should be given after tests are conducted and their use warranted.
What can I do?
- Many illnesses like simple coughs, colds, mild diarrhea and skin infections tend to run a self-limiting course of about 3 to 7 days and usually do not need antibiotics. Adequate rest, fluids, balanced diet and mild painkillers will serve the purpose.
- Never give antibiotics without consulting a doctor. Do not even start the antibiotic treatment on the pretext that you will confirm the course started by you on meeting the doctor the next day. Antibiotics will mask the child's symptoms partially, delaying the correct diagnosis.
- Do not start antibiotics based on your limited knowledge. Doctors opt for specific antibiotics based on individual germs and illnesses.
- Do not use partially used or left over suspensions or syrups of antibiotics. These tend to deteriorate on storage.
- Always check the label for instructions before use.
- If you are using suspension, shake the bottle vigorously before use so as to deliver a uniform concentration of the drug every time.
- Avoid giving antibiotics on a full stomach or with milk or antacids. These may hamper the absorption of antibiotics from the stomach.
- Complete the full course of the medicine even if the child looks and feels fine after a few doses. Some of the germs might remain due to incomplete dosage and result in a relapse.
- Do not rely on other children's symptoms or earlier episodes to start the treatment. Children's symptoms vary based on their age, types of germs causing illness and their own individual differences.
- Dispersible kid tablets are convenient, easy to use (since they dissolve easily), and have minimal chance of dosing errors.
- Many antibiotics (ampicillin, amoxycillin, etc.) cause mild side effects such as abdominal discomfort and occasional diarrhea. Don't worry, these are temporary.
- Let the doctor know your child's medical history, instances of asthma if any and allergies before he starts the treatment.
- Look out for unusual reactions while the child is on the antibiotics. Inform your doctor immediately if the child develops severe itching, swelling of the body or dark urine.
- There is a popular belief that if an antibiotic did not work for a child once before, it will not be effective in future ailments. This is not true. The normal colonies of bacteria that reside in a person's body can change over time, and have different resistance and sensitivity patterns to specific antibiotics.
- It is felt that bodies develop resistance to antibiotics, therefore stronger drugs should be be used for subsequent infections. The real reason an antibiotic does not always work for a subsequent infection is that it may have killed the susceptible bacteria in the child's body but permitted resistant bacteria to flourish and cause the new infection. If this is the case, another antibiotic will be needed.
- Parent often think that antibiotics are needed any time a child has a fever even if it is a viral infection because antibiotics will prevent secondary bacterial infections. Viral infections can be resolved completely without antibiotics. Overuse of antibiotics for viral infections can set lead to the child developing secondary bacterial infections that are resistant to commonly used antibiotics.
- There is a myth that antibiotics make children sleepy or tired. It is the infections that make children tired, not the antibiotics.
90 degrees -- What we do not know yet
- More children are treated in the U.S. with antibiotics for inflammation of the middle ear, or otitis media, than any other child health problem. More than five million cases are diagnosed every year. But now, a scholarly review of over one hundred studies by a pediatrician concludes that antibiotics help only one in eight children with ear infections.
- Children who are given antibiotics in their first three months often wheeze at 15 months of age. However, this wheezing is probably more due to the presence of chest infections than to the use of antibiotics.
- Children who receive antibiotics within their first six months of birth increase their risk of developing by age 7 allergies to pets, ragweed, grass and dust mites and asthma, according to study conducted at Henry Ford Hospital in Detroit. However, they are less susceptible to these effects if they live with at least two pets, namely dogs or cats, in the first year.
- Children who are given antibiotics in their first three months often wheeze at 15 months of age.
- the 2001 Allergy and Asthma Report, the first immunodeficiency syndrome was identified in 1952. This document tells us that since that time, “more than 95 immune syndromes have been identified, with new conditions coming to light every day.” The report goes on to say that research indicates that “increased antibiotic use in human infancy may be associated with increased risk of developing allergies. 
- Physicians prescribe antibiotics for more than half of children with sore throat, exceeding the expected prevalence of strep throat, and used nonrecommended antibiotics for 27 percent of children who received an antibiotic prescription, according to a study. 
- Researchers at St George's Hospital in London found GPs wrote 6.5m prescriptions for children in 2002. This compares to 12.4m scripts in 1993.
More on Antibiotics and children
What can I do to help
- Antibiotics and Children: An Overview
- Antibiotics And Children: Tips For Parents
- Guidelines For Antibiotic Use
- Antibiotic Myths
- Children given fewer antibiotics