What are the sounds of the season in my pediatric office? Coughing, sneezing and wheezing. It's upper respiratory season and I'm seeing a lot of viral illnesses.
With the winter season in full throttle, no one wants to be sick, so parents and patients still “want” me to prescribe antibiotics for a plethora of viral illnesses “because it is a busy time of year, we are traveling and can’t be sick."
According to a recent article in issue of Pediatrics, pediatricians write more than 10 million antibiotic prescriptions unnecessarily every year. Antibiotics won’t help a viral upper respiratory infection and in many instances might be causing more harm than good. That is sometimes a hard concept to explain to parents.
Everyone wants to be well sooner than later. Parents don’t want to be sick and never want their children to be sick or feeling cruddy, yucky, pathetic or pitiful. We are the parents so we can "fix it” right?
Unfortunately, a virus is bigger than any concerned parent, and even an antibiotic won’t “fix it”. In many cases the only cure is “tincture of time” and that is often bitter medicine to swallow.
An antibiotic that is prescribed for a cough or cold is typically broad spectrum and will kill good bacteria that are beneficial to our bodies. An antibiotic is not very specific and by hitting everything in your body it may upset the normal bacteria and lead to symptoms such as diarrhea or abdominal cramping.
In many cases of a viral illness it may be more appropriate to avoid an unnecessary antibiotic and to “wait and see” how the illness progresses. If a child has worsening of symptoms or a change in symptoms it is better to re-examine the child than to just prescribe an antibiotic.
Unfortunately, fall/winter URIs do not go away quickly. In most cases, it takes 7-14 days to get over the congestion, cough, and sore throat no matter what you do.
I have patients who are seen at outside clinics with a negative strep test, then given antibiotics and do not get any better. That good old Z-pack just doesn’t do the trick! By the time I see them the sore throat has developed into a classic upper respiratory infection and the antibiotic has not helped at all. Good rule of thumb: if you are told you have a viral infection, you should not be getting and antibiotic.
Viruses are also quite contagious so it is not uncommon for the entire family to succumb to the cold. Keep up hand washing and good cough hygiene and don’t assume and antibiotic will help, it may do more harm than good!
That’s your daily dose for today. We’ll chat again tomorrow.