| A: This is a wonderful question! It used to be, “why can’t my child have an antibiotic for this cold?” It is refreshing to hear, “can antibiotics be harmful.” The answer is yes- when they are unnecessary.
People become immune by building up antibodies and by other body defense systems. Antibiotics themselves have no effect on our immunity. Their effect is to help make the germs immune to treatment. One of the biggest problems in health care today is the over prescribing of antibiotics for viral illnesses.
What’s the harm?
Antibiotics were thought to be the magic bullet that would cure illnesses caused by bacteria, such as pneumonia, meningitis, and ear infections. These bacteria proved to be smarter than we thought. The more bacteria are exposed to antibiotics, the more they mutate or change. Newer antibiotics are being developed as a counterattack, but the bacteria are winning the race.
The result is called bacterial resistance. For example, antibiotics that originally were extremely effective for ear infections no longer work, resulting in a frustrating round after round of various antibiotic treatments. For some infections we are back where we were before Fleming discovered penicillin—nothing works.
The major causes of bacterial resistance
- Inappropriate use of antibiotics for viral illnesses such as colds, runny noses (even with greenish discharge), sore throats, croup and most cases of bronchitis and coughs.
Antibiotics are not effective against the common viral infections of childhood. A famous physician, Sir William Osler said, “the only way to treat a cold is with contempt”.
- Repeated and multiple courses of antibiotics also lead to resistance. In addition, the more antibiotic use, the greater risk of a drug allergy.
When are antibiotics needed?
Bacterial infections require prompt antibiotic treatment. For the vast majority of infections, the primary care clinician can tell whether it’s more likely a bacterial vs. viral infection, and whether antibiotics may be of benefit. Some indications for the more common infections of childhood include:
- Strep throat
- Pneumonia
- Sinus infections.
- Ear infections
Serious infections like meningitis, and some infections with resistant bacteria are treated with more powerful intravenous antibiotics in the hospital.
What can parents do?
- Understand the differences between viral and bacterial infections, and that it’s best to let the body fight viral infections on its own.
- Discuss antibiotics with your primary care clinician to learn his or her view on the specific cause of any infection.
- Don’t pressure your clinician for antibiotics.
| -- Take Home Message -- |
| Antibiotics are not effective for the common viral illnesses of childhood, such as colds, most coughs and bronchitis, croup and non-strep sore throats. Over prescribing of antibiotics is the leading cause for the emergence of resistant bacteria. Parents should understand the difference between viral and bacterial infections, talk to their clinician about the specific cause of any infection, and not pressure for antibiotics. Their child may well be better off without them for many illnesses. |
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