If you’ve been seeing a lot of your pediatrician lately, you’re not alone. Winter is the busiest time of the year in doctors’ offices, as colds, ear infections, and the flu get passed around like kids’ hand-me-downs. While no one enjoys having a sick child, treating those ailments often means an increased use — and potential misuse — of antibiotics.
Antibiotics are powerful medicines that are good for treating bacterial infections such as ear infections, pneumonia, and bacterial sinusitis. But viral infections — which can cause runny noses, colds, coughs, sore throats, ear infections, or upper respiratory infections — are never cured by antibiotics. The problem is, it is sometimes difficult for doctors to determine whether some illnesses are bacterial or viral in nature.
“If you have a cold with nasal discharge, you shouldn’t expect an antibiotic, because you don’t need one,” says Dr. Stephen Threlkeld, an infectious disease specialist with Infectious Disease Associates in Memphis. What’s more, the overprescription of antibiotics is leading to a growing community health risk.
Pneumococcus (streptococcus pneumoniae), is the single greatest bacterial cause of illness in children, according to Dr. Deborah Nelson, associate professor of pediatrics at the University of Tennessee Health Science Center. This common bacteria, which has 90 different strains, is carried by people in the back of the throat and generally doesn’t make us sick. But certain strains of pneumococcus can cause serious infections, including otitis media (an infection of the middle ear), pneumonia, meningitis, and sinusitis.
The use of antibiotics to treat simpler infections has created resistant strains of the bacteria, which are becoming more and more difficult to treat. Since ear infections are common in young children, a lot of physicians overdiagnose this ailment, says Dr. Katharine Cox, an ER pediatrician with Baptist Memorial Hospital-East. Taking repeated doses of antibiotics increases the likelihood that a child will have an infection that can’t be treated with front-line penicillins like Amoxicillin and Cephalosporins, says Cox. That means physicians must turn to other penicillins and prescribe higher doses to effectively treat patients.
“The medical profession is extremely concerned about the rise of resistant strains of pneumococcal bacteria,” says Nelson. “In the 1940s when penicillin was first introduced, it killed everything. Now, it’s only effective for certain strains of bacteria.” According to a 1998 article in the journal Pediatrics, the past several years have seen a rapid increase in the number of strains resistant to penicillin
Why should parents be alarmed? Children who attend day care centers are more apt to be exposed to resistant forms of the bacteria. Couple that with taking more than two or more courses of antibiotics a year and the American Academy of Pediatrics warns, “The more antibiotics prescribed, the higher the chance that your child will be infected with an antibiotic-resistant bacteria. If infected with resistant bacteria, your child might need to be treated in the hospital,” since resistant bacteria only respond to more powerful medicines.
So what’s the answer? Doctors say both physicians and patients must break the cycle of antibiotic overuse.
Do I Need an Antibiotic?
Here are some helpful tips when seeing your pediatrician:
¥ Ask questions, such as “Is the prescription of antibiotics necessary?” Don’t expect your child to be treated with antibiotics every time he gets sick. “If a child is being seen for a fever or cough, ask your physician why she’s prescribing an antibiotic,” says Cox. “Find out whether your child needs it.”
¥ Make sure your child completes the medicine prescribed. Stopping when he show signs of improvement could increase bacterial resistance by killing the weaker bacteria only.
¥ Keep your child at home during recovery.
¥ Allow your child to recover more fully before sending him back.
¥ Teach your child to wash his hands regularly with soap and water. This helps stop the spread of infection.
[This story originally appeared in Memphis Parent.]
