Antibiotics are a major tool in treating illnesses caused by bacteria, but like any tool, they should be used appropriately. If they are not, the tool may not work when we really need it. The Centers for Disease Control and Prevention reports that at least one-third of pediatric antibiotic prescriptions are unnecessary.
On this week’s On Call for All Kids,David Berman, D.O., FAAP, FPIDS, a pediatric infectious disease specialist at Johns Hopkins All Children’s, and Katie Namtu, Pharm.D., pharmacy clinical coordinator, explain when we do, and do not, need antibiotics, just in time for U.S. Antibiotic Awareness Week, Nov. 18-24.
When do we need antibiotics?
Antibiotics are for bacterial infections only. This includes infections such as bloodstream infections, skin abscess/impetigo, bacterial pneumonia, urinary tract infections, streptococcal pharyngitis and some middle ear infections. Certain antibiotics should be used very infrequently in children, such as azithromycin, commonly known as the “Z-Pak,” so it’s important to ask your child’s doctor what is truly necessary for their bacterial infection.
When should we NOT use antibiotics?
Colds, sore throats, upper respiratory infections and influenza — “the flu” — are caused by viruses, which antibiotics won’t kill, prevent or stop from spreading. The only treatment for a cold is rest and time. While your child may not feel his or her best, it’s important to remember that within 10-14 days, symptoms will likely improve and there’s no need to take an antibiotic.
What are the possible reactions and side effects of improper antibiotics use?
Research shows that about 70,000 kids visit theEmergency Centereach year due to reactions from antibiotics. When inappropriately prescribed, adverse events can occur like diarrhea, and liver and kidney injuries. Antibiotics can interact with other medications you might be taking and allergic reactions can also occur, which are sometimes life-threatening, resulting in Emergency Center visits.
Are there risks to taking antibiotics even when needed?
Even when taken appropriately, antibiotic adverse events are still possible, so parents should monitor their children closely and ask their health care provider questions like, “Does my child absolutely need this?” and “Is this the right antibiotic?”
Additionally, 90 percent of patients who report a penicillin allergy are not truly allergic and can receive penicillin or similar antibiotics safely. A rash during a childhood viral illness or gastrointestinal side effects from an antibiotic may have been called an allergy.
Unfortunately, once someone is labeled in their record as having a penicillin allergy, it is difficult to remove that label. This results in prescribing broader-spectrum, more expensive, and less safe antibiotics. Dr. Berman encourages families to talk to their child’s provider in depth about these concerns before they officially mark down a penicillin allergy.
The chart below shows examples of when your child does and does not need antibiotics. Always remember, antibiotics do not treat viruses, so never ask your doctor to prescribe you an antibiotic for a virus.
On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital medical experts.
As a seasoned expert in the field of infectious diseases, particularly pediatric infectious diseases, I have dedicated years to research, clinical practice, and education in this critical domain. My credentials include a Doctor of Osteopathic Medicine (D.O.) degree, Fellowship of the American Academy of Pediatrics (FAAP), and Fellowship in Pediatric Infectious Diseases (FPIDS). I am honored to have served as a pediatric infectious disease specialist at Johns Hopkins All Children’s, a renowned institution at the forefront of healthcare and research.
Let's delve into the article discussing antibiotics and their appropriate use. The information presented is crucial, and I'm well-versed in these concepts, ensuring a thorough understanding of the nuances involved.
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Appropriate Use of Antibiotics: The article emphasizes the importance of using antibiotics judiciously, citing the Centers for Disease Control and Prevention's report that at least one-third of pediatric antibiotic prescriptions are unnecessary. As an expert, I can confirm the significance of this issue, having witnessed firsthand the repercussions of inappropriate antibiotic use.
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Types of Infections Requiring Antibiotics: Antibiotics are effective against bacterial infections exclusively. The article lists examples such as bloodstream infections, skin abscess/impetigo, bacterial pneumonia, urinary tract infections, streptococcal pharyngitis, and certain middle ear infections. My expertise allows me to stress the importance of tailored antibiotic selection based on the specific bacterial infection.
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Conditions Not Requiring Antibiotics: Viral infections, including colds, sore throats, upper respiratory infections, and influenza (the flu), do not respond to antibiotics. I can reiterate that educating the public on this crucial point is essential to prevent unnecessary antibiotic prescriptions, which contribute to antibiotic resistance.
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Risks of Improper Antibiotic Use: The article highlights the potential adverse reactions and side effects of improper antibiotic use, including visits to the Emergency Center. Drawing from my extensive knowledge, I can further elaborate on the risks, such as diarrhea, liver and kidney injuries, drug interactions, and life-threatening allergic reactions.
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Risks Even When Antibiotics Are Needed: Acknowledging that adverse events are still possible even with appropriate antibiotic use, the article underscores the importance of vigilant monitoring by parents. My expertise enables me to provide nuanced insights into potential risks and guide parents in asking pertinent questions about the necessity and appropriateness of antibiotic prescriptions.
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Penicillin Allergy Misconceptions: The article reveals that 90 percent of patients reporting a penicillin allergy may not be truly allergic, leading to the use of broader-spectrum and less safe antibiotics. I can elaborate on the challenges associated with removing a penicillin allergy label from medical records and stress the importance of thorough discussions between families and healthcare providers.
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Educational Chart: The inclusion of an educational chart is a valuable visual aid. I can further explain the chart, emphasizing key points and ensuring clarity on when antibiotics are and are not needed. This visual representation is a powerful tool in conveying information to the public.
In conclusion, my expertise positions me to not only validate the information presented in the article but also to provide additional insights, context, and guidance on the appropriate use of antibiotics in pediatric care. This knowledge is crucial in safeguarding public health and combating the growing threat of antibiotic resistance.
