Antibiotics are medicines used to treat bacterial infections. When used in the appropriate scenario, they can make your child recover quickly and completely. Many parents request for a course of antibiotics from the doctor when their child falls ill, but are often denied it.

Why are most doctors hesitant to prescribe a course of antibiotics for your child since it can do wonders for their recovery?

Common illnesses in children

Antibiotics are used to kill bacteria but are ineffective against viruses. As the majority of illnesses in childhood are viral in origin, antibiotics are not useful at all. Consider the common illnesses in children: common cold, flu, gastroenteritis and hand foot mouth disease. These conditions are all viral in origin.

Hence during most consults, no antibiotics are prescribed. In the majority of cases, the fever will last for 3 to 5 days and by day 5 the child would be much better even though no antibiotics are given. All your child requires are rest and some symptomatic management.




However there may be a few exceptions to the rule:

• Prolonged fever with worsening cough

If your child’s fever persists beyond 5 days or if the cough is worsening with breathlessness, this may indicate the presence of an evolving lung infection (pneumonia). Antibiotics may be required after a consult with your doctor. Blood tests or chest X-ray may be performed.

• Sore throat

Streptococcus is a bacteria that can cause high fever with a sore throat. Antibiotics are required. However, remember the majority of sore throats are caused by viruses. Your child’s doctor will advise you on the appropriate management.

• Sinus infection

In some children, the presence of high fever with purulent and persistent nasal discharge with headache may be an indication of a sinus infection. Nasal washouts with antibiotics are needed for complete recovery.

• Ear Infection

Not all ear infections are bacterial in origin. Your doctor will advise you if a course of antibiotics is needed.

• Urinary tract infections

Children with isolated fever are often screened for the presence of urinary tract infection. If diagnosed, oral or intravenous antibiotics are prescribed. Urinary tract infections are always caused by bacteria.

What is the safe age to start antibiotics?

Safety of antibiotics is not dependant on the age of the child. Anyone from the age of day one can take antibiotics, as long as it is indicated. For example, some newborns require a course of antibiotics soon after birth if they are septic (severe infection). As the immune system of the newborn is immature, antibiotics are critical to ensure their best chance of recovery. The dosage of the antibiotics will be calculated based on the weight of the child so there would not be any overdose or use of antibiotics that are ‘too strong’ for the child.

What is the problem with antibiotics?

Every time your child is prescribed a new medication or a course of antibiotics, he/she is exposed to the potential side effects of the new medication. Hence only use medication when it is really needed. Frequent use of antibiotics may also build up your child’s resistance to antibiotics such that over time, he/she may require stronger antibiotics with each illness.

From a public health perspective, frequent irresponsible use of antibiotics will result in new resistant strains of bacteria emerging that may eventually not respond to any of our available antibiotics.

What to do if your child is prescribed a course of antibiotics?

If the doctor has prescribed a course of antibiotics for your child, do not be overly fearful too. Take the antibiotics as instructed, and complete the course. This will ensure your child recovers quickly and completely. If you stop the course of antibiotics halfway, the bacteria will not be completely eradicated and may resurface again to cause recurrence of the fever.

Your child may require a stronger and longer course of antibiotics should that happen. If there are any leftover antibiotics, discard it completely. Do not share antibiotics amongst your children, even if their symptoms appear similar. Always consult a doctor before administering any antibiotics to your child if they were meant for your other child.

Antibiotics are very useful medications to combat bacterial infections, provided they are used in the appropriate setting. Always consult a doctor when your child falls ill. He will asses and determine if the illness is viral or bacterial in origin. And trust the doctor when he says there is no need for antibiotics!

By Dr Goh Siok Ying, Paediatrician, KidsHealth Paediatric Clinic (www.kidshealth.sg).

This article was first published in The New Age Parents e-magazine.

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