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When to Use Antibiotics

Unnecessary use of antibiotics can lead to bacteria becoming resistant to these medications. Learn when and how to use them.  

Stephanie C. Chiang, M.D., MPH

Contributor

Stephanie C. Chiang, M.D., MPH

Palo Alto Medical Foundation

Parents may often perceive antibiotics as a cure-all for every illness. But although antibiotics are a powerful tool for fighting bacterial infections, there are downsides to using them. Stephanie C. Chiang, M.D., MPH, a pediatrician at the Palo Alto Medical Foundation, understands the desire of parents to do all they can to help a sick child feel better faster. However, using antibiotics too often and in cases where they do not help, such as for viral illnesses, can lead to the emergence of dangerous bacteria resistant to current antibiotics.

“When parents come in with their sick child, they want them to get better as quickly as possible and may assume an antibiotic prescription is the answer,” Dr. Chiang says. “However, antibiotics should only be prescribed when truly necessary.”

The danger of drug-resistant bacteria is indeed real. The Centers for Disease Control and Prevention has declared antibiotic resistance as one of the world’s most urgent health problems.

Girl taking pill

When to Use Antibiotics

Antibiotics are only effective for bacterial infections and will not cure or shorten the length of viral infections, such as the common cold, most sore throats (bacterial strep infection is an exception), the flu and infections that cause vomiting and diarrhea.

Viral and bacterial infections can cause similar symptoms, which makes telling them apart based on symptoms tricky. When an illness could be due to either, doctors may recommend waiting to see if the illness gets better on its own. Since viral infections are much more common in children than bacterial infections, this nearly always does the trick. In fact, it’s normal for most children to get between seven to 10 viral infections a year. Antibiotics won’t stop the spread of these viral infections or help someone with a viral infection feel better.

Antibiotics: Do's and Don'ts

If your child has a bacterial infection (such as strep throat, pneumonia, an ear infection or urinary tract infection) and your doctor prescribes antibiotics, make sure you follow these important steps, Dr. Chiang says.

  • Always complete the entire course of antibiotics as prescribed by your child’s doctor, even if your child is feeling better. This will help ensure that the infection has been fully eliminated.
  • Discard any leftover medication once the course is completed. Call the California Poison Control System at (800) 222-1222 or check the Food and Drug Administration website for information regarding the safe disposal of medication.
  • Do not share your child’s antibiotic medication with other children. The dosage may not be correct as antibiotics for children are often prescribed based on weight. In addition, it may not be the right medication for the other child’s illness.

“Parents should also know that antibiotics can have side effects,” Dr. Chiang says. “The most common are allergic reactions and an upset stomach that might include nausea and loose stools.”

Researchers are also examining what antibiotics do to the body’s helpful bacteria, such as those that live in the human gastrointestinal system and help us digest food. Repeated treatment with antibiotics does appear to change the number and types of helpful bacteria in the body, which may be another good reason to not use antibiotics for viral illnesses. However, this is a very new field of research and it should not stop you from using antibiotics when they are called for, as untreated bacterial illness can pose a risk to your child and other family members.

Beyond the Antibiotics: What Else You Can Do

Make sure your child gets plenty of rest and fluids to help his or her body fight the infection. If your child’s condition has not improved once the course of antibiotics is completed, check in with your child’s doctor.

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