While antibiotics have saved millions of lives since they were first prescribed in the 1940s, overuse has made many less effective in killing the bacteria that cause illness. While they still are important weapons in fighting disease, it's important to understand if, and when, antibiotics are safe for children.
How do antibiotics work?
Both bacteria and viruses cause disease. Bacteria are living, one-celled organisms, and antibiotics kill them by stopping their growth and reproduction. Viruses are different: They are not considered "alive" and grow and reproduce only after they've invaded other living cells. While the body's immune system can fight off some viruses, antibiotics are ineffective against them.
When are antibiotics useful?
Colds, sore throats, coughs, fevers and many ear infections are caused by viruses and should not be treated with antibiotics. But sometimes those symptoms may be part of a more serious condition. For example, pneumonia, whooping cough, urinary tract infections, sinus infections or strep throat have symptoms that mimic those caused by viruses but are caused by bacteria and can effectively be treated with antibiotics. In addition, some children have conditions that make it harder to heal, in which case antibiotics may be prescribed. Those conditions include cleft palate, Down syndrome and immune disorders and having a cochlear implant.
Antibiotics and children
The first three years of life are particularly important to a child's development, and doctors are very careful about prescribing antibiotics in young children. If an illness is mild, your doctor may recommend observation or non-antibiotic treatment. But there are times when antibiotics are the right treatment for infants, particularly in the case of high fever, moderate to severe ear pain or symptoms of pneumonia.
Types of antibiotics
Different antibiotics work on different types of bacteria. Here's a list of antibiotics that may be prescribed for children:
- Penicillins (amoxicillin and penicillin G). These are typically prescribed as the first-line therapy for ear infections and bacterial sinus infections, given twice a day, usually for 10 days.
- Beta-lactamase inhibitors (amoxicillin-clavulanic acid or Augmentin). These are usually prescribed for more complicated ear infections, for children with a history of recurrent ear infection, for more complicated sinus infections and for some forms of pneumonia. They're given twice a day, usually for 10 days.
- Cephalosporins (cefdinir, ceftibuten, etc.). These are also prescribed for complicated ear infections, pneumonia and for children with a history of recurrent ear infection and for bacterial sinus infections.
- Macrolides (azithromycin and erythromycin). These are usually prescribed for whooping cough and milder forms of pneumonia, and can be given for shorter courses, such as three or five days. A one-time dose is sometimes prescribed.
- Sulfa drugs (trimethoprim-sulfamethoxazole). These are typically prescribed to treat resistant staph infections and urinary tract infections.
Disadvantages and side effects of antibiotics
It is possible for problems to occur when antibiotics are used to treat conditions in children. Frequent and inappropriate use of antibiotics can cause bacteria to change and build up resistance to antibiotics, requiring higher doses for effective treatment. Antibiotics also kill the good bacteria in the body, which can cause diarrhea. In some cases, antibiotics cause bad bacteria, like Clostridium difficile (or C. diff), to proliferate and cause infections that are hard to control. Antibiotics can also cause allergic reactions, like rash and nausea in children.
How to use antibiotics
If your child is sick for longer than a few days or if symptoms worsen, see your doctor. Your child may be prescribed antibiotics. If so, follow directions carefully. Make sure to give your child the full prescribed amount of antibiotic each time and for the full prescribed amount of time. Antibiotics take time to work, and your child may not show improvement for a few days after starting the antibiotics. Never save any leftover antibiotics.
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