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.