When you take your sick child to the doctor – be it for cold, flu, fever or stomach pain – the first thing you expect the doctor to recommend is an antibiotic. But, is this the right way to go?
By Ashwin Dewan
Antibiotics are substances given to treat bacterial infections. However, as with everything, too much of antibiotics can be bad. Overuse of an antibiotic can result in the growth of strains of bacteria that the drug won’t kill. In the article, 'Antibiotic Overuse in Kids: Lessons Learned,' writer Theoklis E. Zaoutis, MD, MSCE, says antibiotic resistance is becoming a major problem and the implications are that we are losing antibiotics that can treat common infections in children.
This article simplifies all you need to know about giving your child antibiotics.
Antibiotics are the most commonly used medication in children. Parents start children on antibiotics for the smallest illness these days. This is a wrong approach for parents. Before giving antibiotics to your child, understand all about when it can be used and what happens with misuse.
There is no specified age limit for children to take antibiotics. It depends on the instructions. A young child can get infected and an old person can get infected, which depends on the bacterial infection.
However, doctors should keep in mind that they should normally prescribe antibiotics only in case of bacterial infections. In some cases, like when the patient is on a ventilator, it may not be advisable to give antibiotics. Generally, for minor ailments, it is advisable to wait for a period of 3 days and undergo some tests before starting on antibiotics.
Antibiotics must be prescribed only when tests show bacterial infection, the total count in blood is high, the neutrophil count (ANC) is high and the baby is very sick. According to Patient in its article, 'Antibiotics,' most infections are generally caused by viruses, where an antibiotic is not of much use. Doctors should not recommend antibiotics for conditions caused by viruses or non-bacterial infections. The choice of antibiotics depends mainly on the type of infection and the germ responsible for the infection.
The Ministry of Health and Quality of Life, a government of Mauritius operated portal, in its article, General guidelines for antibiotic prescription, suggests antibiotics may be prescribed immediately if the child is systematically unwell due to suspected bacterial infection. In some cases, antibiotics may be prescribed later if symptoms do not subside in accordance with the expected course of the illness.
Antibiotics should be prescribed only when there are clinical signs of bacterial infection and the blood clinical investigation shows bacterial infection, says Dr Kumar. Prescribing antibiotics unnecessarily for all types of fever, cough and cold will result in antibiotic resistance. In course of time, if your child gets an infection, the antibiotic will not be able to work effectively due to overuse.
The article, Combating the rise of antibiotic resistance in children, published in PubMed, National Center for Biotechnology Information, says that more children were given antibiotics than other drugs. However, excessive use has led to an increase in the emergence of resistant bacterial strains resulting in antibiotic resistance.
According to InfectionControl.tips, six main causes of antibiotic resistance have been linked to:
• Over-prescription of antibiotics
• Non-completion of the course
• Rampant overuse of antibiotics in livestock and fish farming
• Inadequate and poor hygiene and sanitation
• Drastically less number of new antibiotics being identified or synthesised
• Poor infection control in health-care settings
Children and parents can also play a part in preventing antibiotic resistance. Centers for Disease Control and Prevention (CDC) suggests few tips:
1) Take antibiotics exactly in the manner and duration prescribed by the doctor.
2) Complete the full course of treatment.
3) Do not save antibiotics for the next illness.
4) Prevent infections by practising good hand hygiene.
Antibiotics are the most commonly prescribed medicine by doctors for almost all kinds of illnesses. But, this can result in some side effects. Know more by going through this ClipBook.
The use of antibiotics cannot be limited entirely but certain ways can be followed to limit their use. Doctors and chemists who prescribe antibiotics should be certain about basic facts – when to prescribe antibiotics, what is viral fever, what is a bacterial infection and how to make adequate clinical diagnosis.
According to abcNews, The Food and Drug Administration has suggested one way to limit use of antibiotic by proposing labels on antibiotics that remind doctors to prescribe them only when truly necessary.It is always good to begin with a lower dosage of antibiotics. If the child is not responding properly, then the dosage could be increased. Also, it is necessary to consider whether the antibiotic is required and whether it will prove effective for the ailment before starting on it.
For example, a viral fever generally takes 3-5 days to settle down. Do not give antibiotics on the first day itself.
The article, The Latest Reason Why Hospitals Should Limit Antibiotic Use, quotes Sean Barnes – author of Impact of Reducing Antibiotics on the Transmission of Multidrug-Resistant Organisms, who says "Reducing antibiotic use in intensive care units by even small amounts can significantly decrease transmission of dangerous multidrug-resistant organisms."
Some side effects of antibiotics overuse in children include vomiting, gastroenteritis, rashes etc. Different antibiotics lead to different side effects.
emedicinehealth says while some common side effects of antibiotics in children include soft stools or diarrhea and mild stomach upset, you should consult a doctor if there is any of the below side effects:
• Abdominal cramps and severe watery diarrhea
• Allergic reaction (shortness of breath, hives, swelling of face, lips or tongue)
• White patches on the tongue.
Antibiotics should be used rationally and judiciously. With proper knowledge and use, antibiotics can prove to be an effective remedy for many of your child’s illnesses.
With inputs from Dr S.P. Senthil Kumar, Consultant Paediatrician, Neonatal & Cardiac Intensivist, Columbia Asia Hospitals, Bangalore.
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