What Is Cook Children's Doing About the ‘Antibiotic Crisis’?

A new study shows that too often, doctors and Advance Practice Providers (Nurse Practitioners and Physician Assistants) prescribe an antibiotic as an answer to all needs. But the truth is that those rampant prescriptions may be causing more harm than good for your child.

The Centers for Disease Control and Prevention (CDC) found that nearly half of all people who enter an urgent care center, or walk-in clinic, with symptoms of a cold or flu leave with a prescription for an antibiotic.

The study found that 46 percent of urgent care patients were prescribed antibiotics for conditions, compared with 24 percent at emergency rooms and 17 percent at medical offices.

Educating families and staff on antibiotic overuse has become a focus of Parul Martin, M.D., medical director of Cook Children’s Urgent Care Centers. She joins the national movement on this topic to improve antibiotic stewardship and has highlighted this topic of concern in her presentations for the Urgent Care Association (UCA).  Additionally, the Cook Children’s Urgent Care Quality Improvement and Research Council is collaborating with the UCA to improve antibiotic prescribing practices nationally.

“Cook Children’s proudly supports a culture of clinical excellence,” Dr. Martin said. “Our practice standards are very high. We follow the American Academy of Pediatrics guidelines and we follow evidence-based medicine across the board, including our primary care offices, our specialties, our Emergency Department and our Urgent Care Centers. Everyone is held to those same high standards. We are continually educating our providers about antibiotics and the treatment of viral illnesses. But we also have to continue to educate the families we treat about the proper use of antibiotics.”

Many families don’t want to leave a doctor’s office without an antibiotic. But Dr. Martin said it’s important that doctors explain to families that too much antibiotic use can be harmful to a child. Education is the key to reaching a long term solution to the current crisis.

“We’re a little more proactive on this issue than some of the other Urgent Care Centers or walk-in clinics you may take your children to if they are sick,” Dr. Martin said. “We don’t have the same pressures that they do to stay in business based on volume. If families aren’t prescribed an antibiotic they may go somewhere else. That’s a tough position to be in because if those clinics don’t satisfy the families, they aren’t going to stay in business. That’s part of what has led us to this antibiotic crisis we are in right now. As caregivers, we have to be unified and responsible about only giving this medication when it’s absolutely necessary.”

For viruses that cause illnesses such as the common cold, also known as an upper respiratory tract infection, antibiotics aren’t effective. Antibiotics don’t stop viruses. They only kill bacteria.

The CDC estimates 47 million unnecessary antibiotic prescriptions are written in doctor’s offices, emergency rooms and hospital-based clinics each year. Furthermore, they estimate up to one-third to one-half of antibiotic use in humans is either unnecessary or inappropriate.

Using antibiotics the wrong way can cause bacteria to grow into superbugs and this could mean a problem for your child.

“Antibiotics are drugs used to treat bacterial infections,” said Marc Mazade, M.D., a pediatrician who specializes in Infectious Diseases at Cook Children’s. “Over prescribing or using antibiotics the wrong way can lead to antibiotic-resistant infections. This means the next time your child is sick, the next infection could be much harder to treat when he or she really needs an antibiotic.”

If you are unsure if you or your child needs an antibiotic, ask your health care provider these 5 questions:

1. “Do I really need an antibiotic?”

2. “Can I get better without this antibiotic?”

3. “What side effects or drug interactions can I expect?”

4. “What side effects should I report to you?”

5. “How do you know what kind of infection I have? I understand that antibiotics won’t work for viral infections.”

Each year in the United States, at least 2 million people get serious infections with bacteria that are resistant to one or more of the antibiotics designed to treat those infections. At least 23,000 people die each year as a direct result of these antibiotic infections, according to the CDC.

“I think what happens sometimes is that health care providers feel pressured to give antibiotics from their patients or in a child’s case, the patient’s family,” Dr. Mazade said. “The parents feel they are doing what is right for their child, but the reality is that they may be causing long-term harm to him or her. If they overuse antibiotics, the next time children need the drug to fight off an infection, antibiotic resistance may make the antibiotic useless.”

Antibiotic resistance happens when bacteria change in a way that reduces or eliminates the ability of antibiotics to kill the bacteria.

You do not need antibiotics for:

• Colds also known as upper respiratory tract infections (URI)
• Most coughs and bronchitis
• Sore throats not caused by strep bacteria
• Runny noses, stuffy noses and nasal congestion
• Seasonal Allergies
• Most earaches
• Bug bites by themselves
• Most Diarrhea
• Most Rashes
• Uncomplicated flu infection and RSV infections