November 25, 2013
News Review From Harvard Medical School -- New Push to Limit Antibiotic Use in Kids
New guidelines aim to rein in excess use of antibiotics in children. The American Academy of Pediatrics (AAP) developed the guidelines with the Centers for Disease Control and Prevention (CDC). The goal is to educate parents and doctors about the risks of using antibiotics for upper respiratory infections when they are not needed. Experts say more careful use will help stem the tide of antibiotic resistance. A CDC report in September noted that 2 million people in the United States each year get infections that are resistant to antibiotics. That means the drugs are no longer effective. The report also said that at least 23,000 people die each year as a result. The AAP published the guidelines in its journal Pediatrics. Their release was part of the Get Smart About Antibiotics Week campaign. HealthDay news wrote about the guidelines Nov. 18.
By Henry H. Bernstein, D.O.
Harvard Medical School
What Is the Doctor's Reaction?
Did you hear about Get Smart About Antibiotics Week? The idea is to teach parents and doctors to use antibiotics only when needed and in the right way.
Antibiotics are drugs that treat infections caused by bacteria. They tend to be used too often. Doctors sometimes give patients antibiotics when they do not really need them.
There are risks associated with using antibiotics. Risks such as:
- Side effects -- anything from a tummy ache to a serious allergic reaction.
- Antibiotic "resistance" -- this means the usual antibiotic no longer works to treat that infection.
- Needless extra medical costs -- who pays for them?
The American Academy of Pediatrics just came out with a clinical report on antibiotics in children. It provides pediatricians with guidelines for when it makes sense to prescribe these medicines.
The report was published in the journal Pediatrics. It focused on three common illnesses in children -- ear infections (otitis media), sinus infections (sinusitis), and throat infections (pharyngitis).
Parents should remember that there are many infections that do not always need an antibiotic. In addition, pediatricians often follow three steps in deciding whether or not to give an antibiotic for any of these illnesses.
Step 1: Decide if the illness is caused by bacteria or a virus.
- This can be hard to tell. Bacteria and viruses can cause similar symptoms.
- Keep specific guidelines for each illness in mind to decide the cause.
- Never prescribe antibiotics for infections thought to be caused by a virus.
Step 2: Think about the benefits and risks of giving an antibiotic.
- Will the antibiotic cure the infection? Or make the child feel better? Will it prevent dangerous complications from the infection?
- What are its possible side effects?
- Could the child develop antibiotic resistance?
- How much does it cost?
Step 3: Prescribe an antibiotic carefully.
- Give the right antibiotic.
- Give the correct dose.
- Treat the illness for the shortest amount of time possible.
- Judge if you can wait a couple days before even prescribing it.
What Changes Can I Make Now?
When your child is sick, an antibiotic may not be the answer. Taking an antibiotic when not needed can do more harm than good. It may cause side effects. It also can increase your child’s risk of getting another infection resistant to that antibiotic.
Remember that antibiotics do not fight infections caused by viruses, such as:
- Influenza (the flu)
- Runny noses
- Most sore throats
- Most coughs
- Most bronchitis (chest cold)
- Most sinus infections
- Some ear infections
Giving antibiotics for one of these illnesses will not help make the infection go away. They also will not help your child feel better. Luckily, these illnesses usually get better on their own within a week or so.
If your child has an infection that the doctor feels is caused by bacteria, the doctor may prescribe an antibiotic. Only give your child the antibiotic the doctor prescribes.
- Do not skip any doses.
- Finish the whole treatment, even if your child is feeling better.
- Do not save any antibiotics to give the next time your child is sick.
Keep in mind that if the doctor does not prescribe antibiotics, this does not mean your child is not sick. Talk with your doctor about ways to help your child feel better. The doctor may recommend:
- Plenty of rest
- Lots of fluids
- A cool-mist vaporizer in your child's bedroom
- Saline (salt-water) nose drops to relieve stuffiness
- Over-the-counter medicines, as directed
What Can I Expect Looking to the Future?
Doctors and parents will work together to use antibiotics correctly. Antibiotics should only be prescribed for children when they really need them. If not, the antibiotic may not work the next time it is needed. Remember that taking an antibiotic is not always the answer. Doctors follow guidelines to use antibiotics in the best way.
Expect your pediatrician to talk with you about giving antibiotics exactly as they are prescribed. The doctor also will suggest ways to help your child feel better without antibiotics.