Too many antibiotics not helpful, could cause harm
CDC, Cook Children’s pediatrician agree on dangers of overprescribing
Parents bring their child to see Audrey Rogers, M.D., with a cold and at the end of the visit, the mom or dad often asks the question, “Aren’t you going to prescribe an antibiotic?”
Dr. Rogers explains that there’s really not a cure for a common cold and then lets them know why she’s not giving the child an antibiotic and why no one else should either.
“I understand this mindset,” Dr. Rogers said. “You come to the doctor and you want to be treated. Parents often want an antibiotic. That’s why they are there to see me. They can’t afford to take time off when their child is running a fever and sick. They think the antibiotic will make the illness go away faster.”
But if the cold is viral, it’s simply going to run its course. The antibiotics will not have any impact on the cold at all. With something like a cold, you just have to wait it out.
The American College of Physicians and the U.S. Centers for Disease Control and Prevention agree with Dr. Rogers. They have issued new guidelines for prescribing antibiotics for acute respiratory tract infections (ARTIs) in adults.
The two organizations advice to adults is similar to Dr. Rogers’ advice to children: Use antibiotics to treat bacteria that causes the likes of strep throat and food poisoning. For common viruses like the common cold and flu, the recommendation is drink extra water and juice, use a cool mist vaporizer or saline nasal spray to relieve congestion.
“It’s not that I’m against antibiotics, but for the right reasons,” Dr. Rogers said. “Pertussis starts with cold-like symptoms, just kind of a mild cough, and after 2 weeks the cough gets much worse. In those cases, not only the patient, but the entire family, will need antibiotics, but once the patient has been infected, expect him or her to have a prolonged cough.
Other times antibiotics may be necessary with illnesses including:
- Sinusitis or secondary bacterial infections, related to a cold.
- Certain skin conditions caused by bacterial infections, such as impetigo.
- Strep throat
- A severe ear infection
“I really do try very hard to limit my prescriptions of antibiotics for bacterial infections,” Dr. Rogers said. “If your child has an ear infection and it’s red and bulging, as a parent I would want antibiotics to help ease my child’s suffering.”
However, other caregivers aren’t as careful with their prescriptions, Dr. Rogers warns. She said this can cause the medication to not be effective or even useless when a child actually needs antibiotics. The infectious organisms adapt to the antibiotics, leaving the patient immune to the antibiotic.
Antibiotics have played a vital role in treating patients with infectious disease for 70 years, Dr. Rogers said. When prescribed the right way, antibiotics can prevent illness and even death. But when antibiotics are prescribed carelessly, they lose their effect.
“We frequently see patients who have been prescribed antibiotics at the doc-in-the-box type clinics,” Dr. Rogers said. “It sometimes seems to me that they have a mandate that everyone must walk out with a prescription. They often prescribe an antibiotic, steroid or prescription cough medicine regardless if the patient needs it or not. None of that stuff works for a cold. In fact, studies have been done that say it makes your child worse. The antihistamine thickens the secretion, so you can’t get the yucky stuff out. That’s how you get better, by getting the mucus out and resting. When we’re sick, especially children, we need lots of rest.”
Dr. Rogers’ advice is to see your Cook Children’s pediatrician. Other options include a Cook Children’s Urgent Care Center or Neighborhood Clinic. If a doctor prescribes an antibiotic, she says it’s Ok to ask if it’s the right thing to do. If the doctor says it’s bacterial or to stop an infection, then proceed.
“There’s no magic cure for the common cold,” Dr. Rogers said. “And unfortunately, too many prescriptions of antibiotics are zapping the magic out of what was once a miracle drug."
About the source
Audrey Rogers, M.D., is located at 3200 Riverfront Drive, Ste. 103, Fort Worth, TX 76107. To make an appointment with her or one of her partners, call 817-336-3800. Like her on Facebook.Dr. Rogers received her undergraduate degree from Emory University in Atlanta, Ga., her medical degree at Southwestern Medical School in Dallas, and completed her pediatrics training at Children's Hospital of Oklahoma. Her special interests are behavioral pediatrics and adolescent medicine. She became board certified in 1989.