Antibiotics: When Are They Appropriate?

Dr. Ronald Grant, Pediatric Hospitalist

As the flu and cold season comes to its annual climax, I’d like to share a few thoughts on antibiotics and when their use is appropriate. First and foremost, it’s important to understand that viruses—the agents responsible for most of these wintertime illnesses—are NOT affected by the use of antibiotics. So what do antibiotics treat? Any infection caused by a bacteria; in kids, things such as ear infections, bladder infections, some skin infections (including MRSA and impetigo) and some forms of pneumonia.

As parents, we want a magic cure for whatever ails our children; as doctors we want to be able to keep the parents happy. Still, giving antibiotics to everyone indiscriminately has a major downside. It’s called resistance. Bacteria happen to be smart little buggers; they mutate, change and adapt to their environment. Studies show that children who receive multiple doses of antibiotics unnecessarily may be more susceptible to serious infections like pneumonia or meningitis, mainly because these “smart bacteria” have changed their profile and no longer respond to the antibiotics that used to kill them.

A prime example of antibiotic misuse occurs when someone with a common cold or upper respiratory tract infection is mislabeled as having “bronchitis.” (Technically, “bronchitis” refers to a symptom complex, not definitive diagnosis.) Receiving antibiotics for viruses such as these ultimately leads to more resistance in the community and ultimately leads to the development of Super Bacteria—infections that are so smart and resistant nothing we have works to dent their newly acquired armor.

So what can you do as parents? First and foremost, understand that most viral respiratory tract infections respond best to fluids as well as the natural immunities the body produces. So have your kids drink lots of water and rest—sleep, the natural immune booster! Also, be vigilant and ask questions. Does my child have an infection that will respond to an antibiotic? Which antibiotic has the best coverage without overkill? And finally, know that judicious decisions regarding antibiotics increases the likelihood they will work the next time you really need them.  Making informed decisions regarding antibiotic use is the best way of ensuring their continued success!        

Dr. Ron Grant
Pediatric Hospitalist
Meriter Hospital

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