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Use and Abuse of Antibiotics

While most parents are happy to see their kids back in school, chances are they’re more likely to come home with more than just homework. Chances are they’ll be coming home more frequently with colds, flus and any other illnesses that might be “going around” school.

When our child is ill, we tend to want to do anything in our power to help them feel better. We want them to be able to resume their normal, day-to-day activities as quickly as possible. Often, we end up at an after-hours clinic or doctor’s office, hoping that a prescription for antibiotics might be the fastest and most effective way of dealing with the illness.

In fact, antibiotics are not always the best course of treatment. Firstly, it must be determined by a physician if an illness is a viral or bacterial infection. Common colds, flus and sore throats are examples of viral infections. In fact, 9 out of 10 sore throats are due to viral infections, while strep throat is due to a bacterial infection. A doctor must take into account symptoms and medical history when judging whether the infection is bacterial or viral. Bacteria that once responded well to antibiotics are now becoming increasingly resistant. Illnesses with a bacterial infection such as urinary tract infections, pneumonia, skin infections, some middle ear infections and meningitis are becoming harder to treat.

Antibiotics are also not without their side effects. Among these side effects are possible diarrhea and stomach upset. Antibiotics can also wipe out the “good bacteria” in your child’s intestinal tract unintentionally. This will inevitably make it harder for antibiotics to work effectively the next time your child may have a bacterial infection.

According to Dr. Nicole Le Saux, a CHEO physician with the Infectious Diseases department, “we should all take an interest in ensuring that steps are taken to prevent bacterial resistance. Responsibility lies not only with physicians, but with parents and caregivers as well. If we can reduce the expectation that a “prescription” will be a quick fix for whatever ails a child, and that there is no need for antibiotics in the case of viral infections, this will go a long way in the prevention of bacterial resistance.” What you can do to prevent bacterial resistance:

  1. Seek your doctor’s advice & ask questions. He/she is the best person to tell you whether the infection is viral or bacterial and whether antibiotics are necessary. It is often difficult to tell if the child has a bacterial or viral infection however, so it is equally important to have the child reassessed by the physician if his or her symptoms do not improve or the child appears to be getting sicker or if fever is persisting. Build a partnership with your child’s doctor, discuss your child’s symptoms and be open to letting milder illnesses run their course without an antibiotic. Discuss ways of managing the illness and symptoms without antibiotics. It has been found that often children with an ear infection who were treated with antibiotics recovered in the same amount of time as those who were not given antibiotics. Sometimes it is better to “wait and see” for a few days and then have your child reassessed by the doctor.

  2. Use medication as directed when prescribed. Antibiotics will be effective only if taken as prescribed by the doctor. Follow the correct dosage, for the prescribed time and don’t save the leftovers for the next time your child is sick. Medication takes a few days to kick in, so don’t expect your child to feel better after a few doses of medication. And when your child does start to recover, make sure he/she finishes the medication for the prescribed time.

  3. Dispose of medication. Unused prescribed medication should not be saved for the “next time”, nor should it be shared among family members. Each illness should be assessed by a doctor and antibiotics should be prescribed on a case by case basis. Antibiotics, as in all medications, have an expiry date and should be discarded by bringing it to your local pharmacy for proper disposal.

CHEO’s Department of Infectious Diseases have recommended these sources for additional information.

In all cases, parents and caregivers are encouraged to seek the advice of their family physician or pediatrician where their child’s health is concerned.

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