Twitter Facebook RSS Feed Print
Daily Dose

The Truth About Antibiotics

1:30 to read

Despite warmer than normal temperatures in much of the country it is certainly already cough and cold season. Our office background music is already a lot of coughing coming from children of all ages…and a few of their parents too. In fact, a few of our nurses and docs are fighting a fall cold as well.

 

This makes it timely to discuss (once again) the difference between a cold which is a viral infection and a bacterial infection (example strep throat).  Viruses are NOT treated with antibiotics!! In other words, antibiotics are not useful when you have the common cold. Asking your doctor to put you on an antibiotic “just in case “ it might help is not advised, and doctors should be taking the time to explain the difference between a viral infection and a bacterial infection, rather than writing an unnecessary antibiotic prescription.  

 

While some people (fewer and fewer young parents) still think an antibiotic is necessary, the overuse of antibiotics has been called “one of the world’s most pressing public health problems”s, by the CDC. Not only does the overuse of antibiotics promote drug resistance, it may also cause other health concerns as well. While antibiotics kill many different bacteria, they may also kill “good bacteria” which in fact help the body to stay healthy. Sometimes, taking antibiotics may cause diarrhea and may even allow “bad bacteria” like clostridium difficile to take over and cause a serious secondary infection.  

 

At the same time that there are too many antibiotic prescriptions being written for routine viral upper respiratory infections, a new study in JAMA also found that bacterial infections (sinusitis, strep throat, community acquired pneumonias), are not being treated with appropriate “first line” antibiotics such as penicillin or amoxicillin.  Of the 44 million patients who received an antibiotic prescription for the treatment of sinusitis, strep throat, or ear infections, only 52% were given a prescription for the appropriate first line antibiotic. When a doctor prescribes a broader spectrum, often newer antibiotic, instead of the recommended first line drug, they too are responsible for increasing antibiotic resistance.

 

So, you should actually be happy when your pediatrician reassures you that your child does not need an antibiotic, and that fever control with an over the counter product, extra fluids and rest will actually do the trick to get them well.  I “brag” about my patients who have never taken an antibiotic…..as they have never had a bacterial illness, and tell their parents how smart they are for not asking for an antibiotic “just because”.

 

At the same time, if your child does have a bacterial infection, ask the doctor if they are using a “first line” drug and if not why…? It could be because your child has drug allergies to penicillins, or that your child has had a recent first line drug and has not improved or has had ‘back to back” infections necessitating the use of a broader spectrum antibiotic.  Whatever the reason, always good to ask.

 

Keep washing those hands, teach your child about good cough hygiene and run don’t walk to get your flu vaccines….November is here and flu usually won’t be too far behind.

 

 

  

Daily Dose

The Best Cold Treatment

1.30 to read

Alright, enough is enough! How could I possible have another cold?  I routinely tell patients with children that it is not unusual for kids to get 8-10 colds a year which seems like once a month from September through April!

If you also think that the average cold lasts anywhere from 7–14 days, then it seems like a child has a cold that lasts most of the year. That is how I am feeling right now.

A cold usually starts off with a little “sniffles” and maybe a sore throat, and you pray that it is just your imagination, and then over several days you  realize that you now feel “yucky”, have more congestion, the sore throat is still there and you are coughing. That is a cold!!!! That is not allergies, nor is it flu. It is that pesky cold virus of which there are an infinitesimal number, and you have succumbed once again. That is my story!

So, with those symptoms AGAIN, and a day in the media research office, I went back to the literature to see if I could find ANYTHING that might lead me to preventing  a cold, curing a cold or making this nasty thing go away any faster. I mean, I am a busy woman and like everyone else, “I really don’t have time for this!” There have been thousands of studies done over the years looking at cold symptoms and their prevention. Studies on Vitamin C from the days of Linus Pauling, to more recent studies for prevention and treatment of upper respiratory infections have really found no benefits to taking vitamin C.

There was one study that showed taking vitamin C might reduce the duration of cold symptoms if taken before a cold begins.  My question is, how do you know that you need to start Vitamin C in anticipation of a cold?  Also, too much vitamin C may cause an upset stomach and diarrhea.

How about Echinacea?  I have been taking Echinacea for years in hopes of “warding off colds”, but the review of the data  showed that Echinacea had no effect in preventing the common cold, studies did show that it might reduce cold symptoms in adults, but studies in children did not produce the same results.  It was also found to increase rashes in those who had eczema (atopy), and allergies to ragweed. I am still taking it, but personally “can’t tell a difference”. You do realize that my opinion alone is not statistically significant. Then there was the whole zinc movement and there are numerous studies that show conflicting results. Some studies did show that those who took 15 mg of zinc daily had a lower mean number of colds and also a shorter duration of cold symptoms.

Other studies did not find a statistical significance for either reducing the number of colds or decreasing symptoms. I have tried all sorts of zinc preparations over the years (even when it was such a hot item I had to order lozenges off of QVC-should I admit that?) and besides tasting horribly I think my cold lasted the same number of days.  Another study of one (not significant), and most would say that the data is still inconclusive.

The hottest new topic is vitamin D.  A study published in the Archives of Internal Medicine in early 2009, analyzed information on vitamin D levels in adult and adolescents.  The results showed that those people with the lowest vitamin D levels (less than 10 ng/ml) were 36% more likely to report having upper respiratory infections that those with higher vitamin D levels (above 30 ng/ml).

Vitamin D is also important for bone and general health, so it is a good idea to be making sure that you are getting adequate vitamin D. The AAP increased the recommended daily intake of vitamin D to 400 IU. I am currently taking a vitamin D supplement in hopes of boosting my immunity as well as keeping my bones healthy.

If you have any ideas or PROVEN remedies, potions, concoctions please send them my way. In the meantime, I continue to drink lots of herbal tea, take hot showers and baths to help the congestion, go to bed earlier than usual, suck on my honey throat lozenges and pray. I also wash  my hands incessantly and even resorted to wearing a mask over the last several days in hopes of warding off germs. My patients think I am playing dress up!

That's your daily dose for today.  We'll chat again tomorrow (cough)! 

Daily Dose

Fight The Flu

1:30 to read

It is National Influenza Immunization Week, and I am hopeful that most everyone reading this has already had their flu vaccine….but if not, it is NOT too late! Just like the after Thanksgiving sales being extended…..your opportunity to be vaccinated has not passed!  Lucky for you, there are still vaccines available. If you act quickly there may be some places having a two for one sale, a coupon for shopping after getting vaccinate or even free vaccines…no excuses, everyone in the family ( over 6 months) may be vaccinated.

All kidding aside, this is an important time to remind people that it is not too late to get your flu vaccine and as of the first week of December there has not been a significant amount of flu in the country. But with that being said, influenza typically circulates December thru February but some years flu may even last into April or May.  But one thing is sure, flu is coming!!

No one is immune from the flu and the best protection is to get a flu vaccine!!  I hear people tell me, “they have never had the flu before so why should I get a vaccine?”, or “ I got sick after I had the flu vaccine, so I am not getting it again”.   Both of those are myths and are just a few of the anecdotes that I hear from patients and their families.

It is recommended that everyone over the age of 6 months receive a flu vaccine as it is the best protection against getting sick from the flu, and by vaccinating everyone we are also protecting those infants under 6 months that cannot yet get a flu vaccine.  Infants have a higher incidence of complications from the flu ( as do children with asthma and other underlying health issues ), and those precious babies born during the late summer and into the winter depend on the community to help keep them healthy. This is especially important for infants and children in day care, as influenza is a respiratory virus that is spread when someone in close proximity has coughed or sneezed. So, check to make sure that everyone in your daycare center is vaccinated, including the parents.

Statistics show that flu vaccination activity drops off after the end of November, but it is never too late to get the vaccine.  Remember,  it does take about two weeks to develop immunity after being vaccinated.  People also tell me, “I think I have already had the flu this year”, but even if you have, you have not had all of the strains of influenza that are in the vaccine and yes…you could get sick again. This years flu vaccine is available as a trivalent vaccine (which contains 2 type A, flu and 1flu B) and a quadrivalent vaccine ( with 2 type A and 2 B strains), and either vaccine is fine….get whatever your doctor, health department, pharmacy, grocery store, or employer has.  Most children over the age of 2 years may also take the live attenuated intranasal flu vaccine ( because how many kids want a shot -right?) and it is a quadrivalent vaccine.

So now is the time to run…not walk to get your flu vaccine!!  Don’t delay, put it on the top of the holiday “to do list”.

Play
460 views in 1 month

Heading to the ER?

Play
913 views in 1 year
Flu

Fight The Flu

Daily Dose

Do Essential Oils Boost Immune System?

1:30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 

 

Daily Dose

Pregnant? Get Your Flu Shot

1.45 to read

If you are pregnant, know someone that is pregnant, or are even thinking about becoming pregnant, you need a flu vaccine!!  (That is not to say that we all need to be thinking about flu vaccine’s right now!)

A study out of Duke University showed that of 1,600 women who delivered during the 2009-2010 flu season, those that had received a dose of flu vaccine delivered more term babies and also delivered babies who had higher birth weights. Women who received at least one flu vaccine during the season were also less likely to require a doctor’s visit for flu prior to delivery and they had lower hospitalization rates.

Another study out of Wake Forest University which was recently published in the Journal of Obstetrics and Gynecology looked at women who had received flu vaccine during their pregnancy.  This study showed that infants born to mothers who received flu vaccine while pregnant were 50% less likely to be hospitalized with flu than infants born to mothers who had not received flu vaccine. This was a study conducted over the years 2002-2009 (before H1N1) Impressive!

Flu vaccine is recommended for everyone 6 months of age and older. Infants 6 months of age and younger have the highest rate of hospitalization for flu related illness among all children.  The only reason that flu vaccine it is not given to younger infants is that the vaccine is not effective. How do we protect those babies, by protecting the mothers who are carrying the child? 

So…bottom line, pregnant women who get their flu vaccines not only protect themselves, they are protecting their newborn infants as well. A mother’s job of protecting her children is life long, but it begins even with a baby in utero. Go get that vaccine, as flu season is upon us!  

That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Flu Cases Rising

1:30 to read

Flu season is definitely upon us and unfortunately it is hitting just in time for the holidays!  I have been on call for the last 2 weekends and I can assure you, flu is everywhere. You name the place and you are probably being exposed somewhere.  That includes the mall (where people are shopping whether sick or well), grocery stores, churches, synagogues, restaurants, day care, schools, airports...the list is endless.   I am saying this because patients continue to ask, “where do you think I got this?”.  

To compound the problem families are gathering for the holidays, so it makes it an even better time for the respiratory viruses to spread.  Those viruses just love this time of year.

Fortunately, despite the flu vaccine not being a “good match” for the Influenza A (H3N2) that is widely circulating, the children I am seeing with the flu (and yes, I myself have already seen 100’s) are not terribly sick.  They do have the typical fever, cough, sore throat, headache and body aches that typically comes with flu, but they are typically only running fever for 1-3 days and when the fever is down they are playing video games, watching TV and baking cookies. I have not seen anyone that has had a serious complication....I am hopeful that this continues.  

Many patients are wondering about using Tamiflu (which is advertising heavily right now). I am using Tamiflu for children who are high risk (under 2 years, have underlying illnesses, are immunocompromised, have significant asthma etc).  For most children the flu can be handled at home with the usual symptomatic treatment, fever control, fluids, rest and parental TLC (tender loving care).  I would always watch for any respiratory distress and make sure your child stays hydrated. In most cases I bet the fever is gone in a day or two and they are left with a nasty cough (same goes for the parents).  I always warn parents to watch for any re-occurence of fever later in the illness, which makes me worry about a secondary infection which would require a visit to the doctor.

Best prevention right now is to continue to get a flu vaccine....some protection is always better than none. Wash your hands, eat healthy, get plenty of sleep and if you are sick- please stay home!!  We’ve got several more months of flu....winter is just really starting.

 

 

 

Daily Dose

Do Essential Oils Boost Immune System?

1.30 to read

Although it is still hot and officially summer, soon everyone will be heading back to school  and coughs and colds (and eventually flu, another topic) will be just around the corner. I had a patient ask me about the use of essential oils. Her 2 1/2 year old daughter is heading to preschool for the first time and she “had heard from her friends that essential oils help a child’s immunity during cold season”.

Unfortunately, there is very little data at all to confirm that statement. I only wish that rubbing a bit of lavender oil on would help prevent the common cold. While it may smell great and be relaxing....there is no data that I can find to show that there is any reproducible science to the claims that essential oils boost the immune system.  

While I was researching I found many sites stating that “eucalyptus oil is an anti-viral” and “peppermint oil is an anti-pyretic (fever reducer)”.  Tea tree oil is touted as being “both anti -bacterial and anti-fungal” (I don’t know of other drugs that can claim both!).  But, I just don’t see any data to support all of this. 

The word essential refers to the essence of the plant the oil is derived from, rather than being “essential” to your health. While in most cases essential oils (which are highly concentrated) used as aromatherapy are not harmful for adults, it may be a different story in children, especially those under the age of 6. While labels may say  “natural” it may not always mean safe.  Many oils are poisonous if ingested and there have been reports of accidental overdoses in children with several different oils. In one report tea tree oil and lavender oil applied topically have been shown to cause breast enlargement in boys.  Oil of eucalyptus and peppermint are high in menthol and cineole.  These substances may cause children to become drowsy have decreased respirations.  While there are articles stating that the use of menthol (Vicks) on a child’s feet may be helpful during a cold for reducing a cough, do not use this if child is young enough to put their feet in their mouths. 

I must say that I sometime use a few drops of eucalyptus oil in the shower when I have a cold as I think it smells great and seems to help “open up” my head. Whether this is in “my mind” or a response from my olfactory centers which sends calming messages to respiratory center is not clear. But, I am not ingesting it or using it topically. 

 

 

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

Can you use homeopathic products to relieve your child's illness?

DR SUE'S DAILY DOSE

Can you use homeopathic products to relieve your child's illness?

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.