Use Antibiotics Wisely

By: Lou Romig MD, FAAP, FACEP, Medical Director

After Hours Pediatrics Urgent Care

There is a lot of misinformation among the public about infections and antibiotics. At After Hours Pediatrics Urgent Care, we are focused on antibiotic stewardship. Our goal is to teach families to use antibiotics wisely to help maximize effectiveness as well as decrease complications related to indiscriminate antibiotic use.

First and foremost, it’s important to know that antibiotics only treat bacterial infections. They do not work on viral infections, which are the cause for most fevers in children. If antibiotics are given when they’re not needed, the patient can experience unwanted side effects and allergies to medication, not to mention lost time and cost. Over time, antibiotic overuse contributes to bacteria changing and no longer being resistant to standard antibiotics that are used to treat ailments, such as tuberculosis, MRSA or ear infections.

Types of Antibiotics

There are three general types of antibiotics.

• Bacterial antibiotics come in oral, shot and cream/ointment form.
• Antivirals treat limited types of viruses and are given in oral and ointment form.
• Antifungals are used to treat yeast and fungi, in cream, ointment or oral form.

As we mentioned, most childhood fevers are caused by viruses, but there are times when children have bacterial infections that need to be treated with antibiotics. Here are the most common examples:  

• Ear infections with pus behind the ear drum(s)
• Sore throat testing positive for strep
• Urinary tract infections with positive urine tests
• Pneumonia, with or without chest X-rays
• Skin infections: impetigo, cellulitis, abscesses

Your child’s pediatrician will use a combination of medical history, physical exam, tests and knowing what infections are currently in the community to know when to prescribe antibiotics for your child.  

Antibiotic Overuse

There are common instances when children and adults alike are unnecessarily prescribed antibiotics. Here are the most common illnesses that often result in unnecessary antibiotic treatment:

• Short-term viral upper respiratory infections, even with yellow or green mucus
• Viral respiratory infections in the chest that cause a bad cough (“bronchitis”)
• Bronchiolitis in infants
• Sore throat without a positive strep test or with a negative strep test
• Ear “infections” with only clear fluid behind the ear drum(s)
• Conjunctivitis (“pink eye”)
• Fever alone

If your child is prescribed an antibiotic for a bacterial infection, and the appropriate antibiotic is used, there should be a noticeable improvement within 24-72 hours. If your child has started an antibiotic, here’s what you should be aware of:

• Antibiotics will NOT stop fever until the infection is being adequately treated.
• If your child isn’t feeling better within 3 days or is getting much worse, it might be the wrong antibiotic OR the infection might be viral and will get better on its own, in its own time.
• If your child starts getting better in less than 24 hours of starting antibiotics, it’s most often not because of the medication, but because they were going to get better anyway.

When you bring your child to their pediatrician, you may receive a prescription for an antibiotic, but with instructions to hold off on starting the treatment until after following your child’s symptoms for a bit longer. In this case, it may not be clear whether the symptoms and signs are due to a bacterial infection, local inflammation or viral infection, and it keeps the family from needing to visit the doctor’s office again if symptoms don’t improve.

Please discuss appropriate antibiotic use with your medical caregivers. At After Hours Pediatrics Urgent Care, our pediatricians are familiar and compliant with current medical standards and will only prescribe antibiotics in appropriate situations as part of our effort to protect your child, as well as general public health.

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