Antibiotics Aren't Always Needed
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Parents need to know that using
antibiotics when they are not the right medicine will not help and may even
cause harm to children.
Antibiotics are medicines used to treat
infections and they target bacteria, not viruses. Before prescribing an
antibiotic, your child's doctor will find out if it is the right medicine to
treat your child's infection.
Read on for answers from the American Academy
of Pediatrics to questions about the use of antibiotics. Talk with your child's
doctor if you have other questions.
Q: My child has a really bad cold. Why won't the doctor
prescribe an antibiotic?
A: Colds are caused by
viruses. Antibiotics are used specifically for infections
caused by bacteria. In general, most common cold symptoms—such as runny
nose, cough, and congestion—are mild and your child will get better
without using any medicines.
Q: Don't some colds turn into bacterial infections? So why wait to
start an antibiotic?
A: In most cases, bacterial
infections do not follow viral infections. Using antibiotics to
treat viral infections may instead lead to an infection caused by
resistant bacteria. Also, your child may develop diarrhea or
other side effects. If your child develops watery diarrhea, diarrhea
with blood in it, or other side effects while taking an antibiotic, call
your child's doctor.
Q: Isn't a nose draining yellow or green mucus a sign of a
A: During a common cold,
it's normal for mucus from the nose to get thick and to change from
clear to yellow or green. Symptoms often last for 10 days.
Sinusitis is a
term that means inflammation of the lining of the nose and sinuses. A
virus or allergy can cause sinusitis and in some cases, bacteria can be
There are certain signs that
bacteria may be involved in your child's respiratory illness. If your
child has a common cold with cough and green mucus that lasts longer
than 10 days, or if your child has thick yellow or green mucus and a
fever higher than 102°F (39°C) for at least 3 or 4 days, this may be a
sign of bacterial sinusitis.
If your child has developed
bacterial sinusitis (which is uncommon), an antibiotic may be needed.
Before an antibiotic is prescribed, your child's doctor will ask about
other signs and examine your child to make sure an antibiotic is the
Q: Aren't antibiotics supposed to treat ear infections?
A: Not all ear infections
are treated with antibiotics. At least half of all ear infections go
away without antibiotics. If your child does not have a high fever or
severe ear pain, your child's doctor may recommend observation
Because pain is often the first
and most uncomfortable symptom of ear infection, your child's doctor
will suggest pain medicine to ease your child's pain. Acetaminophen and
ibuprofen are over-the-counter pain medicines that may help lessen much
of the pain. Be sure to use the right dose for your child's age and
size. In most cases, pain and fever will improve within the first 1 to 2
There are also eardrops that may
help ear pain for a short time. You can ask your child's doctor if your
child should use these drops. Over-the-counter cold medicines
(decongestants and antihistamines) don't help clear up ear infections
and are not recommended for young children.
Your child's doctor may prescribe
antibiotics if your child has fever that is increasing, more severe ear
pain, and infection in both eardrums.
Q: Aren't antibiotics used to treat all sore throats?
A: No. More than 80% of sore
throats are caused by a virus. If your child has sore throat,
runny nose, and a barky cough, a virus is the likely cause and a test
for "strep" is not needed and should not be performed.
Antibiotics should only be used to
treat sore throats caused by group A streptococci. Infection caused by
this type of bacteria is called "strep throat." Strep throat generally
affects school-aged children and not children younger than 3 years.
If your child's doctor suspects
strep throat based on your child's symptoms, a strep test should always
be performed. If the test is positive, antibiotics will be
Q: Do antibiotics cause any side effects?
A: Side effects can occur in 1
out of every 10 children who take an antibiotic. Side effects may
include rashes, allergic reactions, nausea, diarrhea, and stomach
pain. Make sure you let your child's doctor know if your
child has had a reaction to antibiotics.
Sometimes a rash will occur during
the time a child is taking an antibiotic. However, not all rashes are
considered allergic reactions. Tell your child's doctor if you see a
rash that looks like hives (red welts); this may be an allergic
reaction. If your child has an allergic reaction that causes an itchy
rash, or hives, this will be noted in her medical record.
How long does it take an antibiotic to work?
A: Most bacterial
infections improve within 48 to 72 hours of starting an
antibiotic. If your child's symptoms get worse or do not
improve within 72 hours, call your child's doctor. If your child stops
taking the antibiotic too soon, the infection may not be treated
completely and the symptoms may start again.
Q: Can antibiotics lead to resistant bacteria?
A:The repeated use and misuse of
antibiotics can lead to resistant bacteria. Resistant
bacteria are bacteria that are no longer killed by the antibiotics
commonly used to treat bacterial infection. These resistant bacteria can
also be spread to other children and adults.
It is important that your child
use the antibiotic that is most specific for your child's infection
rather than an antibiotic that would treat a broader range of
If your child does develop an
antibiotic-resistant infection, a special type of antibiotic may be
needed. Sometimes, these medicines need to be given by IV (vein) in the
Q: What are antiviral medicines?
A: Influenza (flu) is a viral
infection that can cause cold symptoms for which an antiviral
medicine will work. An antiviral medicine may be prescribed
for children that are at higher risk of becoming severely ill if they
get the flu. For most other viruses causing cough and cold symptoms,
there are no antiviral medicines that work or are recommended.
Using antibiotics safely
Keep the following in mind if your child gets sick:
Antibiotics aren't always the
answer when your child is sick. Ask your child's doctor what the
best treatment is for your child.
Ask your child's doctor if the
antibiotic being prescribed is the best for your child's type of
bacterial infection. For instance, certain antibiotics such as
azithromycin are no longer effective for the bacteria causing most ear
and sinus infections.
Antibiotics work against bacterial infections. They don't work on colds and flu.
Make sure that you give the medicine exactly as directed.
Don't use one child's antibiotic for a sibling or friend; you may give the wrong medicine and cause harm.
Throw away unused
antibiotics. Do not save antibiotics for later use; some
out-of-date medicines can actually be harmful. Call Poison Help at
1-800-222-1222 or check the US Food and Drug Administration Web site at
www.fda.gov for information on the safe disposal of
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Copyright © 2010 American Academy of Pediatrics, Updated 05/2014. All rights reserved.