Antibiotics - To Give Or Not To Give......

A sneeze and you look warily in your child’s direction

A cough and you are shaking your head and rolling your eyes

And a warm forehead and you have already imagined the worst diseases possible

Such is parental attachment and love.
​
If you are a parent it is impossible to disentangle yourself from the clutches of paranoia. We are all victims of it.
​
It is nightmarish to have a sick child at home. Not only is it heart wrenching to watch your child suffering. It also disrupts any semblance of routine that you may claim to have in the house on regular days when everyone is well.

When your child is sick, you are ready to do just anything to make them well soon – and that is when you reach for antibiotics.

You know that antibiotics cure infections – and the cold and fever are obviously because of infection. So why not use this easily available remedy? Why not give antibiotics? You reason with yourself.

But even as you reach for the antibiotic – somewhere at the back of your mind – something tells you shouldn’t.

And so rages the eternal debate in the mind of the parents of all sick children.

Should we give antibiotics or should we not?

A lot of these doubts come from not knowing enough about antibiotics.

These are the answers to some of the questions that parents ask about antibiotics

​
“Why do doctors wait for three to four days before starting an antibiotic?”

When we train as doctors – we are taught this in medical school.
“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 teaching young doctors the futility of using antibiotics in viral infections.

Learn more about Viral infections

Antibiotics kill bacteria. They have absolutely no effect on infections caused by viruses. It is common knowledge that most childhood infections are usually 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 this is usually evident in 3 – 4 days.

“But children really do get better rapidly once the doctor starts antibiotics. How does that happen?”

When a doctor starts antibiotics – he is certain – that what started out as a viral infection – has now turned into a bacterial infection and that is why – when he starts antibiotics – the child immediately improves.

When you start antibiotics yourself without prescription – 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 is usually an illusion.

Viral infections are at their worst on the third day and start to get better by the fourth day. It is usually the third day that parents find unbearable. 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 next day the child is better 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. This would have happened anyway – even if the antibiotic had not been started.

 “Is there a way to know if an infection is bacterial or viral?”

Yes there are several clinical signs that doctors are trained to identify that tell them that an infection is a bacterial infection. And what these  clinical signs tell the doctor – can usually be confirmed by lab tests.

While most childhood infections are viral – there is the possibility of infections being bacterial as well. Also viral infections considerably lower the immunity of the child that they infect. This makes it easier for bacteria to overpower the immune system and cause a bacterial infection. So sometimes there may be a bacterial infection superimposed on a viral infection.

Bacterial infections must be treated immediately by starting antibiotics. And only a doctor can tell if an infection is bacterial or viral. That is why it is important to consult a doctor as soon as your child falls sick. And also trust his advice

“Is there any harm in giving an antibiotic even if the infection is not a bacterial infection?”

Yes. Giving an antibiotic when it is not required can do a lot of harm.

The human body houses millions of bacteria. Most of these bacteria are useful bacteria and help in the normal functioning of the body. Antibiotics however do not consider the role of the bacteria in the body before they kill them. When an antibiotic is administered – it indiscriminately kills any bacteria that it comes across in the body. The loss of good bacteria make the body weak and prone to more infections.

The loss of good bacteria can also lead to stomach upsets and diarrhoea

By taking antibiotics when they are not required you build antibiotic resistance. Resistant bacteria are difficult to cure with antibiotics. It takes longer to cure future infections and the antibiotics have to be stronger. If these stronger antibiotics don’t work – hospitalization and use of injectable antibiotics could also be required

Sometimes resistant bacteria do not cause infection in the person who has taken the unnecessary antibiotics because the person who has taken the antibiotics has good immunity. But these bacteria are still alive and can be passed on to other people. At special risk are siblings of the child who has taken the antibiotics and other family members.

Viral infections are terrible. They make you and your child miserable. However the answer to feeling better lies in getting rid of the symptoms. And relief from symptoms does not require antibiotics. Instead of requesting your doctor to start antibiotics – ask for something that will relieve symptoms and make your child feel better.
 

---