Last Updated: 30 July 2019
One of the questions that haunt parents off and on, time and again, through their parenting journey is the question “Should I start antibiotics for my child when he is sick?”
Sneezes, coughs and fevers are the nightmares that interrupt every family’s routine at regular intervals and they can be extremely frightening. It is very easy to imagine the worst when it is your little one who is ill and that is what we invariably do. Also it is no fun to have a sick child at home. It is horrible to see your child suffer and it makes a mess of any routines that you may have in place and any plans that you may have made. And when your life is spinning out of control like that – all you want to do is give them a magic potion and make them well again – and that is when you reach for antibiotics.
But even as you reach for the bottle – questions and more questions pop into your head. You have heard somewhere that it is not a very good idea to start children on antibiotics. You have read somewhere that overuse antibiotics is bad. And so you stop and wonder – “When my child is sick – should I give antibiotics or not?”
6 questions about starting antibiotics that bother parents
Question 1 :
My doctor always says “Wait for three to four days before starting an antibiotic”
Why wait? I want my child to get better as soon as possible
Yes – you are anxious for your child to get well soon – believe me – so is your doctor.
Almost everyone knows that antibiotics cure infections, and yes they do. But what a lot of people don’t know is – that antibiotics only cure bacterial infections. The reason they should be used with restraint in childhood infections is – that most childhood infections are caused by viruses. And antibiotics are useless – if not harmful when given for viral infections
That is why doctors wait for 3 -4 days before they start antibiotics. They want to be sure the infection is not a viral infection before they start antibiotics. And it is usually clear in 3 – 4 days if the infection is bacterial or viral
No doctor wants his patient to be sick for even a moment more than absolutely necessary – but doctors know that “A viral infection left untreated – gets better in 7 days. And if it is treated with antibiotics – the patient gets better in 1 week.”
This is a humorous way of saying that it is absolutely useless to use antibiotics in viral infections
Question 2 :
If childhood infections are caused by viruses – how come my child gets better rapidly – as soon as I start antibiotics? (And I sometimes start antibiotics on my own because I am tired of asking my doctor to start antibiotics)
It is very difficult to endure your child’s suffering and when your child is sick you are understandably impatient – but you shouldn’t be. Starting your child on antibiotics without your doctor’s prescription is very wrong.
Doctors start antibiotics when they are certain that the infection in question is a bacterial infection or when they are certain that what started out as a viral infection has now turned into a bacterial infection. That is why – when a doctor starts an antibiotic – your child immediately recovers.
When you start antibiotics on your own – things sometimes improve too. This is not because the antibiotic starts acting against the virus or because the disease was a bacterial infection in the first place. The improvement that you see is usually an illusion.
In the normal course of events – viral infections are almost unbearable on the third day and start to get better by the fourth day. And it is this unbearable third day that parents find most difficult to get through. They are unable to tolerate their child’s suffering and they are tired of the havoc the illness in the family is wreaking on their lives – and so they start antibiotics. The child gets better immediately and all the credit goes to the antibiotic. What has really happened here however is – that by the time the antibiotic was started, the viral infection had run its course and was on its way out anyway. The illness would have been over anyway – even if the antibiotic had not been started.
Question 3 :
What tells my doctor that the infection is bacterial or that the infection that was a viral has now turned bacterial?
There are several clinical signs that can be used to differentiate bacterial infections from viral infections. And in the years that doctors spend in medical colleges – doctors are trained to identify these signs. These clinical signs of bacterial infection can usually be confirmed by lab tests.
Question 4 :
How do viral infections turn into bacterial infections all of a sudden?
When a child has a viral infection. The virus lowers the immunity of the child considerably. This makes it easier for bacteria to overpower the immune system and cause a bacterial infection. So what starts out as a viral infection – turns into a bacterial infection in 3 – 4 days’ time because the child’s lowered immunity allows the bacteria in. So it is the case of a bacterial infection superimposed on a viral infection
Question 5 :
If the doctor is going to start only after the third day – is it OK to wait for the third day of fever to consult a doctor?
No. Never wait to consult the doctor when your child is sick. While it is highly probable that your child is suffering from a viral infection, a bacterial infection can never be completely ruled out. And if the infection your child is suffering from is bacterial and not viral, it must be treated immediately with antibiotics. Waiting for 3 days to start an antibiotic in case of a bacterial infection can be extremely dangerous. And so it is not wise to wait for three days to see a doctor. Consult a doctor as soon as your child falls sick. And also trust his advice
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Question 6 :
“Can there be a problem if an antibiotic is started – even if the infection is not a bacterial infection?”
Yes. Giving an antibiotic when it is not required can do a lot of harm.
Our body is home to millions of bacteria. Most of these bacteria are useful bacteria and help in the normal functioning of the body. These useful bacteria in fact are protective in many ways and prevent infections. Antibiotics however do not wait to identify bacteria in the body and consider the role they are playing in the body before they kill them. When you start an antibiotic – it indiscriminately kills any bacteria that it comes across in the body and this can do more harm than good, by making your child more sick than he was before.
Problems with taking Antibiotics when they are not required
1. Unnecessary antibiotics reduce your immunity
Good bacteria that help to keep the body healthy are killed and this makes the body weak and prone to more infections.
2. Antibiotics cause stomach upsets and diarrhea
Antibiotics kill the good bacteria in the digestive tract. And the loss of good bacteria can lead to stomach upsets and diarrhoea. This is a side effect of antibiotics whenever they are taken and for whatever reason. However, this side effect is a needlessly inflicted injury when antibiotics are taken for viral infections
3. Superfluous antibiotics cause drug resistance
Antibiotics taken unnecessarily and frequently – build drug resistance. Drug resistance is dangerous because infections caused by bacteria that are drug resistant are difficult to cure with regular antibiotics in regular doses. Future infections therefore become more difficult to cure. Infections with resistant bacteria need stronger antibiotics to be administered for longer. And if these stronger antibiotics don’t work – hospitalization and use of injectable antibiotics could also be required
4. Drug resistance spreads in the family
Resistant bacteria are not just dangerous for the child who has been given the antibiotic – they are dangerous for other people in the family as well – especially the siblings of the sick child. If the person who has taken unnecessary antibiotics has good immunity, the resistant bacteria don’t affect him – they move on to other people in the family with weaker immunity. At special risk are the siblings of the child who has taken the antibiotics
What can you do for a child who is suffering from viral fever?
Most viral infections cannot be treated. Treatment of ordinary viral infections should not even be attempted because they build your child’s immunity. What you can do however is relieve the symptoms of the viral illness. Relief from symptoms does not require antibiotics it requires measures like steam inhalation, nasal drops and drugs that bring down fever. Instead of requesting your doctor to start antibiotics – ask for something that will relieve symptoms and make your child feel better.
Suffer through your child’s viral infections with patience and use the time to bond with your little one.