When are antibiotics really necessary?

Your child has been sick for a week, has a runny nose and coughs all the time? Your three-year old woke up this morning complaining of an earache. Are antibiotics necessary?

Colds, the flu and most cases of acute ear infections are caused by viruses, not bacteria, so antibiotics will be in no way effective against them. And yet, many parents head down to the doctor’s office and vigorously demand a prescription for antibiotics when their child is ill.

Why should we worry about a simple antibiotic prescription? True, the risk of adverse effects from most antibiotics is very low. Nausea, diarrhea or rashes may occur in some cases, but serious adverse effects are very rare. However, on a global scale, unnecessary prescriptions cause a lot of harm. Every time bacteria are exposed to antibiotics, they can evolve and become a little more resistant, even against the most powerful antibiotics. We are now seeing more and more infections around the world that are leaving the medical community powerless because the bacteria are resisting our whole antibiotic arsenal. Antibiotic resistance is therefore everybody’s business.

Having greenish nasal discharge or sputum does not mean that antibiotics are necessary – viral infections also cause this type of symptom. Even ear infections are usually caused by a virus, which means antibiotics are neither necessary nor effective. In fact, the latest treatment recommendations for otherwise-healthy children between 6 months old and the age of 12 is to wait if the child has been in moderate pain for less than 48 hours and the fever does not exceed 39°C. If the situation worsens between 48 and 72 hours, the pertinence of treatment should be re-evaluated. For the child’s comfort, however, it is important to treat the pain and fever with an analgesic such as acetaminophen or ibuprofen. In order to reduce the risk of a bacterial superinfection, the flu and pneumococcal vaccines are also recommended for young children. These two vaccines are part of the recommended immunization schedule for Quebec children.

Modern medicine allows us to fight many diseases that were incurable a hundred years ago. But sometimes, less is more – don’t demand an antibiotic prescription for your child. Trust your physician’s judgment. And if your doctor does prescribe them, make sure they are taken as directed. Questions? Don’t hesitate to discuss them with your pharmacist.