Why is the overuse of Antibiotics a Problem?

Antibiotics are magic bullets that help doctors to fight bacteria. But overuse of antibiotics is a huge problem. When we overuse antibiotics not only does it affect the person who is using the antibiotic adversely, it also affects the people around them and the whole population at large.

How do Antibiotics work?

Antibiotics are drugs that are designed to work on bacteria. They are constructed in such a way that they attack certain vital areas in the body of the bacteria – which then results in the bacteria being killed.

Antibiotics would have been the magic swords against all the infections in the world – if all the infections in the world were caused by bacteria. But not all infections are caused by bacteria.

Infections are caused by viruses, parasites, worms and fungi. And in children – because of their poorly developed immune system – most infections are caused by viruses.

Viruses have a completely different body structure from that of bacteria. And antibiotics do not work on viruses because they do not have the body parts that the antibiotic is designed to attack.

So antibiotics do not kill bacteria

Also read When my child is sick – are antibiotics good or bad for him?

What are the viral infections that don’t need antibiotics?

A viral infection can be differentiated from a bacterial infection only by a doctor. So whenever your child has an infection of any kind – it is best to consult a doctor immediately.

However, it is still important for parents to understand which infections are likely to be viral infections in children.

  1. In most cases colds and running noses in children are caused by viruses
  2. In the early stages – a cough of short duration is likely to be due to viruses
  3. Many of the childhood fevers are caused by viruses
  4. Many of the fevers that are accompanied by skin lesions like Chicken Pox, Measles, Rubella etc. are caused by viruses.
  5. Some stomach infections can also be caused by viruses.

Also read Viral Fever –  What you should know about it

So what should you do when your child is sick?

When a child has a cough, cold, sore throat or a fever – the best thing to do is to consult a doctor on day 1 of the disease.

A clinical examination is usually enough  to differentiate a bacterial infection from a viral one. And when in doubt the doctor will request investigations to ascertain whether an infection is bacterial or viral.

When the doctor thinks your child has a viral infection he/she will ask you to wait it out and just try to relieve your child’s symptoms with medicines to reduce the fever and bring down the body ache and cold etc.

If it is a bacterial infection your doctor will start antibiotics immediately

In most cases your child’s body will be able to fight the virus and recover from it in 3 – 4 days. In some cases however, your child’s immune system may not be strong enough to overpower the virus and when his/her body is already weak because of the virus – bacteria may begin to attack as well.

Your doctor will usually ask for a review in 3 days. If it looks like the bacteria have taken over from the viruses and the infection is now a bacterial infection. Your doctor will prescribe antibiotics at this point.

Also read Can a viral infection turn into a bacterial infection

What is overuse of antibiotics?

When an antibiotic is started without first determining whether the disease in question is being caused by a bacteria or a virus – that is overuse of antibiotic.

You may start the antibiotic out of fear. You may start the antibiotic out of love  because you can’t bear to see your child suffer. Or you may start the antibiotic because the child has an exam or you need to go to work and staying home with an illness is not a viable option. But whatever the reason – ultimately if the doctor does not certify that it is bacterial infection on the basis of his clinical examination or on the basis of the laboratory tests done. It is overuse of antibiotics.

Why is it harmful to overuse antibiotics?

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Antibiotics kill bacteria and that should be good news for us.

But what happens if you take too much of antibiotics?

When too much antibiotic is taken it can lead to –

  1. Reduced Immunity There are two types of bacteria in our body – good bacteria and bad bacteria. Good bacteria keep us safe. Bad bacteria cause infection. We take antibiotics to kill bad bacteria. But since antibiotics cannot distinguish between good bacteria and bad bacteria – they end up killing good bacteria too. When we lose good bacteria we lose the soldiers who stand guard for our body and protect us against various diseases. And this makes us fall sick more often.
  2. Antibiotic resistance – Overuse of antibiotics also leads to antibiotic resistance. Which means that in the future – the antibiotic can no longer kill the bacteria and cure the disease
  3. Diarrhea and stomach upset – A side effect of the overuse of antibiotics is diarrhea and stomach upset which can then make the child more sick because of dehydration and the inability to absorb the food that he/she is eating.

So antibiotics do have harmful effects. They are not always the saviors. They can actually cause disease if they are not used correctly.

What causes antibiotic resistance?

When antibiotics are overused in infections where they have no role to play – it leads to drug resistance.

Using an antibiotic  when it is not needed is like sharing war strategies with the enemy.

When an antibiotic is used without it being really required – the method it uses to kill bacteria is learnt by the bacteria that are normally present in our body.

The next time disease-causing bacteria enter our body – this information is passed on to these bacteria and they learn how to avoid being killed by the antibiotic.

This is terrible for us because the drug that was supposed to save us – now no longer works.

What are the consequences of antibiotic resistance?

When bacteria become resistant to antibiotics  they are no longer killed by them.

This means that antibiotic resistance means that we have fewer drugs to fight bacterial infection.

Antibiotic resistance is dangerous for everyone but is especially dangerous for children – because they have weak immune systems

If adults around a child – for example parents – take antibiotics unnecessarily – they become a source of drug resistant bacteria for the child. With their strong immune systems the parents may not fall prey to the bacteria. But the child with his weaker immune system may fall prey to this resistant bacteria.

And this bacteria can then not be cured by antibiotics and the child may need higher and higher antibiotics. The oral antibiotics may not work and she may need injectable antibiotics.

How many antibiotics are allowed in a year?

A child with a good immune system is unlikely to require more than 3 courses of antibiotics in a year. This is because most childhood infections are likely to be viral infections. This of course may vary and depend on the clinical condition of the child as judged by the doctor in charge.

If a child requires more antibiotic courses in a year – it will be important to work o the child’s immunity and work towards building the immune system and making the child stronger and more resilient to infections

How can antibiotics be taken safely?

The only way to stay safe while taking antibiotics is to use antibiotics only when prescribed by a doctor

  1. Take it in the dose prescribed
  2. Take it for the number of days prescribed
  3. Take it at the exact time intervals prescribed

Never use antibiotics without consulting a doctor because if you do you are at risk of overusing them and suffering the dangerous consequences of doing so.

Read the WHO document on Antibiotic Resistance here

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