You inform the Doctor that your child has had a fever for 3 days, a cough and runny nose, and hasn’t been eating. You’re in a panic. Just yesterday, your Mother-in-law said your child “might have pneumonia” and needs antibiotics. The Doctor checks your child and tells you “It’s OK. She just has a virus” and all that is needed is supportive care, TLC, and maybe some Tylenol or Ibuprofen if the child is uncomfortable.
“Wait,” you cry, “Aren’t you going to give her some antibiotics? She’s sick!” Just then, the nurse rushes in and tells the Doctor that he’s needed in the Trauma Room. He whips out his prescription pad and scrawls a prescription for Amoxicillin, and hurries away towards his next patient. As you walk away, you’re satisfied because you have a prescription for antibiotics. As the Doctor walks away, he rolls his eyes upward and thinks “another panicky Mother!”
So…what just happened? Who’s right? What are the facts?
The facts — based on solid evidence from numerous studies — demonstrate the following:
1. Most illnesses suffered by children are viruses.
2. Antibiotics are only helpful for bacterial infections.
3. Overuse or inappropriate use of antibiotics is potentially harmful for adults and even MORE harmful for children
4. Having a “cold” is GOOD for children, as is having a fever and “not eating” for several days. (I’ll explain this later)
5. Among 4000 children who have a “common cold,” only ONE would benefit from antibiotics (that’s a whole lot of children getting unneeded medication. We’ll see later why this is bad medical practice)
6. Physicians will prescribe antibiotics 65 percent of the time to children if perceived by the physician that the parents want the antibiotics, whether or not the antibiotics are needed. If not requested by a parent, only 12 percent of children will be prescribed antibiotics.
7. Since antibiotics were first discovered and used in the 1940’s, almost every type of bacteria has become stronger and more resistant to antibiotics; this is a direct result of overuse of antibiotics or, more appropriately, using them when they are not needed.
8. Resistant bacteria can cause serious health problems (including death) to you and your family.
9. According to the Centers for Disease Control, antibiotic resistance is considered one of the most pressing and serious worldwide public health problems today.
Now, let’s look more closely at some of the above points.
How, you ask, could one possibly state that it’s a good thing when my child is sick? The answer is simple: There are hundreds of different viruses which exist and with which your child comes in contact; Mother Nature (or whichever term you wish to use) uses that opportunity when your child becomes ill with a virus, to strengthen your child’s immune system. It’s like taking the immune system to the gym. Kids may get sick 4 or 5 times a year while their immune system is becoming more formidable. By the time they reach adulthood, their immune system is tough enough to fight off most viruses. This process has been going on in humans for hundreds of thousands of years. Efforts to hinder this process would lead to a significantly weakened immune system.
Providing there are no complications, be glad your child is ill.
And fever? Parents often present to the clinic with the complaint that their child “has a fever.” We have been brought up to think that fevers are “bad.” The fact is: fevers turn on the body’s immune system and help to overcome the virus. A child can easily sustain a fever of 104° without harm. The prevailing advice today is: only bring down a fever if your child is uncomfortable. The higher the fever does not relate to how serious is your child’s illness. In turning on the immune system to combat the same virus, one child’s fever may be 101°, while another one’s fever is 104°. It’s normal for a fever to worsen at night, and for fevers to wax and wane during the course of an illness. And remember: antibiotics do not bring down a fever.
Another concern parents have is that their child is not eating when they are ill. Most cultures feel that a child must eat to obtain the proper nourishment to fight the illness. The fact is: it takes a lot of energy for the system to effectively fight off a virus (that’s why you feel weak and tired when you’re ill); it also takes a lot of energy to digest food (that’s why you feel lazy after a big meal). Mother Nature, in her infinite wisdom, wants to utilize all available energy to fight the infection, not to “waste” energy in digesting food. All humans have plenty of “stores of food” specifically designed to be utilized during times of illness (think of “baby fat”). This is food that is easily converted to nourish the ill child without taking from the necessary energy used in defending the child’s body from the attacking virus. The bottom line: if your child is ill and not eating anything, don’t feel compelled to make him or her eat. Really, all they need are fluids (and water is generally sufficient).
Most illnesses are viral. The facts: colds, bronchitis, sore throats (except strep throat), most ear infections, stomach infections, influenza, and all the usual illnesses children acquire, are nearly always viral in nature. Yes, on occasion a child may become ill with a bacterial infection — but this is relatively rare (and we will discuss bacterial infections shortly). We know antibiotics do nothing for viruses—only for bacterial infections. So…you may ask, what’s the harm if your health provider prescribes an antibiotic for your child’s viral infection? Well, as a parent, you would probably feel better that you’re doing all you can for your ill child — but are you helping or hurting? The facts are: over prescribing antibiotics causes the “bad” bacteria to mutate in such a way that they can become “super bacteria”; additionally, they will develop resistance to the usual antibiotics. Further, antibiotics can wipe out the “good” bacteria (Yep! We all have “good” bacteria in the body which serves important roles in our health), leading to potentially serious health problems directly related to the use of antibiotics. The greater the use of antibiotics (especially when not needed) leads to a greater resistance of “bad” bacteria.. Without judicious use of antibiotics (such as saving them ONLY for bacterial infections) many bacteria will become completely resistant to nearly all known antibiotics. The facts: this has already happened worldwide. Some bacteria are now killing people because they are more potent and deadly than before, and they no longer succumb to the use of antibiotics. And that is the single most important reason to restrain the use of antibiotics.
Think of your children: what will happen if one of your children develops a serious bacterial infection and there is no longer an antibiotic which will kill that bacteria?
One study showed that from birth to age 18, a person really has need for antibiotics only 2.2 times. And how many times has your provider written your child a prescription for antibiotics by, say, the age of 5?
Approximately 90 percent of all antibiotics written, are simply not needed — often, they are written for obvious viral infections. Why is this? This is something very important for all parents to understand and will be addressed in Part Two.
But before we end Part One, permit me to give you several more facts about why parents should NOT want to give their children antibiotics unless absolutely necessary. In addition to causing more potent and resistant bacteria, studies illustrate a relatively significant percentage of children are actually harmed by antibiotics. Some antibiotics can cause abdominal pain, diarrhea, and other adverse effects. Nearly 4 percent of children develop allergic reactions to antibiotics: rashes, hives, facial swelling, and persistent itching. These unfortunate children often end up at a clinic or the ER for treatment of their allergic reaction to an antibiotic they likely did not need.
Severe allergic reactions can occur, compromising a child’s airway. Rushed to the Emergency Room, the child may have a tube placed down the throat enabling them to breath, an IV started to give emergency medications, and admitted to the hospital for one or two days. Consider the consequences to your child emotionally (especially if you had insisted that the child receive antibiotics for a mere viral infection), not to mention the consequences to your bank account when you receive the hospital bill.
Pearls of wisdom to remember
1. Antibiotics do not kill viral infections, only bacterial infections; most human infections are viral (this includes cough, colds, flu, sore throats, bronchitis, and even most ear infections)
2. If you ask for antibiotics for your child’s illness (even though it is likely a virus), your health provider will likely give it to you. This is not a good thing. Don’t ask for antibiotics.
3.Inappropriate use of antibiotics causes resistance among bacteria, thereby making the antibiotic impotent in its attempt to kill off the more serious bacterial infections. Again, don’t ask for antibiotics
4. Antibiotics themselves can lead to serious side effects, allergic reactions, and other unwanted health problems. You DO NOT want your child to have antibiotics unless absolutely needed.
5. When your child is ill, it is likely a viral infection. Symptoms such as fevers, not eating, cough, runny nose, and sore throat are no need to hit the panic button. These are normal. However, if your child seems more ill than usual, is having any difficulty breathing, is becoming worse rather than better…or you’re simply not sure, stop by your friendly clinic and seek medical advice.
Bill Weiss is a certified physician assistant at Marianas Medical Center.
