Judicious Use Of Antibiotics

By Veronica Ron, MD — Danbury Hospital

“But doctor, aren’t you going to prescribe antibiotics for my child?” This is a question I am frequently asked by parents when I tell them their child has a “cold,” an upper respiratory tract infection caused by a virus. This is usually a self-limiting infection, the course of which can not be modified by the use of antibiotics. It sounds unreasonable that towards the end of the twentieth century, after medicine has achieved such strides in diagnosing and treating diseases which were considered untreatable only a few years ago, a virus can still cause such discomfort and aggravation; but that is the truth.

In many families both parents are working. Having a sick child, therefore, may mean that one of the parents could not return to work, or that the child may have to be sent to daycare center or to school not feeling well. Unfortunately a quick “fix” does not apply to viral diseases.

Most patients with the common “cold” will have symptoms lasting four to six days. Sore throat can at times persist for up to two weeks, even without the development of bacterial infection. As mentioned above, this course can not be shortened by the use of antibiotics. Injudicious use of antibiotics has been the main reason we are witnessing the emergence of bacterial resistance to antibiotics. This resistance makes it more difficult to treat infections caused by bacteria, which have traditionally been susceptible to antibiotics. Thus, there is a need, at times, to select newer antibiotics. These antibiotics are more expensive. The real problem, though, is that once bacteria stop responding to the common antibiotics benign infections can develop into devastating illnesses with extremely unfavorable outcomes.

In a recent survey of pediatricians, many have admitted to surrendering to parent’s wishes to start their children on antibiotics in cases where the physicians felt there was no need for such treatment.

There is a need to educate parents and physicians alike about the potential harmful effects of inappropriate use of antibiotics. Parents have to better understand the nature of their children’s illnesses. They have to be informed about the right therapy for the specific disease. Better understanding will yield less pressure on physicians to prescribe medications which do not contribute to the patient’s well being. This kind of cooperation between parents and physicians will not only improve our children’s health, it will also assist future generations by slowing down the emergence of microbes which resist treatment and turn a benign illness into a lingering and hard to treat ailment.