3 myths about antibiotic use every parent should know
The Doc Smitty and the over prescribing of medication to kids
The Centers for Disease Control recently finished up a week of increasing awareness to a huge problem that could be one of the biggest risks our children face as they grow older. You might be thinking obesity or global warming or some other more “popular” topic. But, it’s actually something much more personal than that.
It could be that amoxicillin prescription that your child took last week.
Antibiotics have been one of the greatest advances in medicine. People used to die frequently from diseases that we now view as simple because antibiotics are readily available. However, the ease of use of antibiotics, combined with what seems to be a low risk associated with them has created a huge and growing problem.
I believe that the biggest reasons why antibiotics are overprescribed deal with several myths surrounding antibiotic use:
Myth No. 1: Parents always want antibiotics.
This myth is one that physicians frequently believe. You would like to think that it doesn’t influence their behavior but it does. A study from 1999 showed that physicians prescribed antibiotics for viral infections 62 percent of the time when they believed that parents wanted them and only 7 percent of the time when they didn’t. Hopefully we’ve gotten better and this gap is closing but still, WOW. The interesting thing about this study is that the physicians often thought that parents wanted antibiotics when, in fact, they did not.
So, this one falls on us. We need to ask more questions about what parents goals are and we need to educate rather than prescribe when antibiotics are not what is best.
Parents if you want to help your doctor understand when you would prefer not to use antibiotics, read this post: Does my child really need an antibiotic?
Myth No. 2: All infections will get better with antibiotics.
Some infections in kids require antibiotics for improvement. Strep throat, urinary tract infections and skin infections will need antibiotics to treat and prevent worsening of the symptoms.
Ear infections don’t always need antibiotics. In older children with less severe disease, a period of waiting can allow the infection to go away without treatment.
Many infections in children are caused by viruses. Flu, colds, sore throats that aren’t strep and many other infections in children simply need a little time and TLC. Mary Suzanne Whitworth, M.D., medical director of Cook Children’s Infectious Diseases adds, “Most viral upper respiratory tract infections start with clear runny nose, maybe fever, and maybe a cough. After a few days the nose drainage is green and then after a few more days it goes away on its own. Antibiotics are not needed for these viral illnesses. The child might have bacterial sinusitis and need antibiotics if the green runny nose lasts for over 7 to 10 or if symptoms worsen after a few days.”
Myth No. 3: There’s no harm in giving antibiotics.
While you might not have ever seen side effects or dangerous reactions to antibiotics, I see them almost every day. Children can have severe, even life threatening, allergic reactions (even if they have taken that antibiotic before and been fine). Because these are rare, they are not a reason to avoid antibiotics when necessary but they are a reason to use caution when antibiotics are not the right treatment in the first place.
Antibiotics can also cause other side effects, most commonly diarrhea. This diarrhea can last weeks and can be quite severe. If the diarrhea is severe (especially if blood or mucous is present) your doctor might have to consider testing for C. difficile which is a potentially serious infection that can be the result of antibiotic use.
Finally, we are beginning to see an increase in the number of infections caused by bacteria that do not respond to the antibiotics we have traditionally used for them. This requires us to use stronger antibiotics which can often cause more side effects. You can see why people are concerned if we continue along the same path but fast-forward 25 or 50 years. What types of bacteria would emerge? This is why we must use extreme caution.
Dr. Whitworth adds, “Antibiotics are important and often life-saving. But each time they are used there needs to be a conscious decision made about exactly why they are indicated, what the best choice is for patient compliance, and what the risks and benefits are. They should not be used just because they are expected or requested.”
Parents and doctors all play a role in decreasing the unnecessary use of antibiotics. Open conversation about the child’s condition, the parents’ expectations and the possible risks and benefits of antibiotics treatment are all important parts of each decision regarding antibiotics.
Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page.He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.