It’s a common scenario: your child has a fever, cough, and thick green mucus coming from her nose. You take her to the urgent care, and they diagnosis sinusitis or an ear infection or bronchitis, and you get a prescription for an antibiotic. Simple, right? Well, in many cases that prescription is not helpful, is unnecessary, and may even be harmful. One study published in 2016 found that over a two-year period in the US, about 30% of all antibiotic prescriptions written were unnecessary.1 Why is that a big deal? Because it can cause a lot of problems, for you, your children, and everyone around you.
Bad for Your Baby
Antibiotics can sometimes have harmful side effects. Of course, this can happen when they are prescribed appropriately, as well, but when prescribed inappropriately, those side effects could have been completely avoided. Up to 10% of children taking antibiotics for ear infections have side effects.2
Some of these side effects include diarrhea, rash, allergic reactions, vomiting, abdominal pain, joint swelling, and a serious inflammatory process called Stevens-Johnson syndrome, which can be fatal. Even when the side effects are minor, they often necessitate another visit to the doctor, not to mention causing discomfort to the child.
In addition, some studies suggest that children who use antibiotics are at a higher risk for developing diseases like asthma and allergies.2
Bad for Everyone Else
When an antibiotic doesn’t cure the problem in a child, the parents frequently ask me, “Is she resistant to the antibiotic?” But this isn’t how antibiotics work. The drug is meant to kill the germ, not the child. So germs get resistant to antibiotics, but people don’t get resistant to antibiotics.
And what most parents don’t realize is that the resistance has more to do with the antibiotics that everyone else is taking, rather than the antibiotics that the child is taking. Simply put, too much antibiotic use will breed resistance in germs. That is, the bacteria will adapt and be able to fight off or resist the medicine, and then that antibiotic will no longer be effective. And this happens in a community where the germ is prevalent. So if your child never takes any antibiotics, but everyone else in the community is using a specific antibiotic, then the germs in the the community will become resistant to that medicine. And when your child finally needs that antibiotic, it won’t work.
And resistance is bred not just by unnecessary antibiotic use, but by incorrect antibiotic use, such as giving your child “leftover” medicine from your or someone else’s prescription (or even your child’s old prescription). And not taking the prescription as directed (skipping doses or stopping the prescription because the symptoms resolved) can also lead to resistance.
What You Can Do
Follow these tips for safer, effective use of antibiotics:3,4
- Understand when antibiotics are helpful, and when they are not: they help when to treat a bacterial infection (pneumonia, urinary tract infection, cellulitis, etc.), but not a viral infection (the flu, colds, sore throats that are not caused by strep, most cases of bronchitis and sinusitis, and some ear infections, among others). Green or yellow nasal drainage is NOT a sign that the upper respiratory infection is caused by bacteria.
- Have a frank discussion with your health care provider about why antibiotics are or are not needed for your child, and find out what other treatments can be used. And ask about the time course in which she should get better
- If antibiotics are prescribed, take them as prescribed. Even if your child seems better after just a few days, take them for the entire time prescribed.
- Safely dispose of antibiotics after you or your child have completed the course. DON’T “save them for later.” See this FDA site for information on safe disposal of medicine.
- NEVER give your child antibiotics left over from someone else’s prescription (or left over from that same child’s old prescription): antibiotics are often targeted to a certain known or suspected bacteria, so not all pneumonias, for example, are treated with the same antibiotic. And some antibiotics are safe for adults, but not children.
- If antibiotics were prescribed for your sick child, and she’s not better by the end of the course, call your doctor.
- If no antibiotics were given for your sick child, and she’s not better by the time she should be, call your doctor.
- Fleming-Dutra KE, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016 May 3;315(17):1864-73.
- Byrne J, Thiel B. Outpatient overprescribing: “cultural shift” needed to spare antibiotics. Infectious Diseases in Children. 2019 January;32(1).
- Centers for Disease Control and Prevention. What you can do.
- American Academy of Pediatrics. Guidelines for antibiotic use.