A Parent’s Guide to Antibiotics

girl_parents_doctor_antibioticsWhen a child gets sick, parents may be surprised if the pediatrician isn’t quick to pull out the prescription pad for an antibiotic.

Most seasonal illnesses like respiratory infections, the flu and the common cold are actually viral infections, for which antibiotics have no effect. In many cases, your child’s doctor will recommend treating the symptoms until the infection runs its course.

“It can be hard for parents because when our children are sick, we want to be able to do something for them,” says Dr. Katherine Andreeff, CHOC Children’s hospitalist. “In the case of viral illnesses, all we can do is support the body in its own process to fight the infection.”

Antibiotics are only effective against bacterial infections, which can include urinary tract infections, blood stream infections and cellulitis, a common skin infection. Some infections – like pneumonia or ear infections – may be either viral or bacterial. Your child’s doctor may choose to prescribe antibiotics or wait it out to see if symptoms improve on their own.

If your child’s doctor prescribes an antibiotic, Dr. Andreeff recommends following these guidelines:

  • Don’t be afraid to ask questions. Ask the doctor what type of infection your child has and whether it is viral or bacterial, and discuss why the antibiotic is justified. “Antibiotics can change our body’s natural balance of good bacteria, so you only want to take them if they are necessary,” Dr. Andreeff says. “Repeated or lengthy courses of antibiotics may cause additional problems.”
  •  Take the antibiotic as directed. If it isn’t taken as frequently as prescribed or for the full duration of treatment, bacteria may survive and your child won’t be fully healed. It also can create antibiotic-resistant bacteria – a real problem as researchers attempt to stay a step ahead and formulate new medicines that will work.
  •  As with any medicine, beware of side effects. According to Dr. Andreeff, “It’s very important to only take medicine when the benefit of it outweighs the risk for side effects. Discuss this with your doctor and tell them about any reactions your child has.”
  • Don’t underestimate viral infections. Even though they can’t be treated with antibiotics, they can be severe. Always consult a doctor when your child is showing signs of illness.

Bottom line: Antibiotics are powerful medicines that are essential in treating certain infections. The key is their appropriate prescription and use.

Read articles about conditions that might require treatment with antibiotics:

  • Kids and Ear Infections
    An ear infection is an acute inflammation of the middle ear caused by fluid and bacteria behind the eardrum. “Usually it starts with a cold, so the child will have ...
  • Meningococcal Disease – What Parents Should Know
    Please take a few minutes to check out these must-know facts and guidelines on Meningococcal disease, as recommended by the Centers for Disease Control and Prevention (CDC).

Kids and Ear Infections

Pic of Boy Covering EarsEAR INFECTION SYMPTOMS
An ear infection is an acute inflammation of the middle ear caused by fluid and bacteria behind the eardrum. “Usually it starts with a cold, so the child will have a runny nose and a cough. Colds can lead to  ear infections in susceptible children,” says Dr. Nguyen Pham, an ear, nose and throat specialist at CHOC  Children’s. “Older kids will pull on their ears and tell you their ears hurt. For infants, symptoms can include  fever, irritability, or changes in their eating and sleeping patterns. A pediatrician can look at the eardrum  to diagnose an ear infection.” Generally, ear infections are treated with oral antibiotics.

PROTECT LITTLE EARS
“The best thing families can do is to have really good hand hygiene,” says Dr. Pham. “Everyone should wash hands constantly. Encourage children to not touch their faces with their hands or rub their eyes,” he says. Colds and the flu can frequently lead to ear infections, so children should be protected against colds and get a flu vaccine, Dr. Pham advises.

HEARING LOSS HELP
“An acute ear infection can lead to temporary hearing loss because of the fluid behind the eardrum. That type of hearing loss will get better over several weeks. If it doesn’t get better, that’s the time to go to the pediatrician or a specialist,” says Dr. Pham. If you suspect your child has hearing loss, ask for an audiogram,  which is a formal hearing test. A pediatrician can perform this test or refer the child to a specialist such as  an audiologist or otolaryngologist.

IS THERE AN EFFECTIVE, PREVENTATIVE SURGICAL TREATMENT FOR CHILDREN WITH FREQUENT EAR INFECTIONS?
Children who have four or more ear infections per year meet the criteria to have ear tubes inserted into the  eardrum. Ear tubes create a drainage pathway for bacteria behind the eardrum to get out, so infections don’t  form. This is a commonly performed surgery in the U.S. and is very effective in preventing ear infections.

FAST FACTS

  • Number of babies born in the U.S. with permanent hearing loss: 3 in 1,000
  • Percentage of children in the U.S. with some hearing loss: 10%
  • Percentage of children who will have at least one ear infection by their second birthday: 90%

View the full feature on Kids and Ear Infections

Dr. Nguyen Pham
Dr. Nguyen Pham
CHOC Ear, Nose and Throat Specialist

PHYSICIAN FOCUS: DR. Nguyen Pham

Dr. Pham specializes in pediatric otolaryngology – head and neck surgery. Dr. Pham completed his residency at the  UC Davis Medical Center and a fellowship at Stanford University. He practiced advanced surgical techniques in airway reconstruction, otological surgery and the treatment of congenital defects at Stanford’s Lucille Packard Children’s Hospital. Dr. Pham has participated in many humanitarian endeavors, including a medical mission to perform cleft lip and palate surgeries in the Philippines and helping patients in New Orleans after Hurricane Katrina. Dr. Pham speaks fluent Vietnamese.

Dr. Pham’s philosophy of care: “My philosophy is to truly listen to my patients and to provide compassionate  care based on the best possible scientific evidence.”

EDUCATION:
UC Irvine School of Medicine

BOARD CERTIFICATIONS:
Otolaryngology

More about Dr. Pham

This article was featured in the Orange County Register on February 24, 2014, and was written by Amy Bentley.

Meningococcal Disease – What Parents Should Know

Please take a few minutes to check out these must-know facts and guidelines on Meningococcal disease, as recommended by the Centers for Disease Control and Prevention (CDC).

What is Meningococcal disease?
Meningococcal disease is a severe bacterial infection caused by the bacterium Neisseria meningitidis, also called meningococcus. Neisseria meningitidis bacteria are spread through the exchange of respiratory and throat secretions like spit (e.g., living in close quarters, kissing, sharing drinks, eating off same fork). People who qualify as close contacts of a person with meningococcal disease should receive antibiotics to prevent them from getting the disease.

Who can get Meningococcal disease?
Anyone can get meningococcal disease, but it is more common in infants and children. Other persons at increased risk include household contacts of a person known to have had this disease, immunocompromised people, and people traveling to parts of the world where meningococcal disease is prevalent.

What are the symptoms?
A common outcome of meningococcal infection is meningitis. When caused by Neisseria meningitidis bacteria it is known as meningococcal meningitis. When someone has meningococcal meningitis, the protective membranes covering their brain and spinal cord, known as the meninges, become infected and swell. The symptoms include:

• Fever
• Headache
• Stiff Neck
• Nausea
• Vomiting
• Increased sensitivity to light
• Altered mental status (confusion)

The symptoms of meningococcal meningitis can appear quickly or over several days. In newborns and infants, symptoms (fever, headache, neck stiffness) may be difficult to notice. The infant may appear to be irritable, inactive, vomiting or feeding poorly.

Another common outcome of meningococcal infection is bloodstream infection, either septicemia or bacteremia, and the more serious of the two is septicemia. When someone has meningococcal septicemia, the bacteria enter the bloodstream and multiply, damaging the walls of the blood vessels and causing bleeding into the skin and organs. Symptoms may include:

• Fatigue
• Vomiting
• Diarrhea
• Rapid breathing
• Cold chills
• Severe aches or pain in the muscles, joints, chest or abdomen
• Red dots which can progress to dark purple rash
Please note: Meningitis and septicemia can sometimes occur together.

If you think you or your child has any of these symptoms, call the doctor right away.

How is Meningococcal disease treated?
Meningococcal disease can be treated with a number of effective antibiotics. If meningococcal disease is suspected, antibiotics are given right away. In some cases the infection has caused too much damage to the body for antibiotics to prevent death or serious long-term problems. Depending on how serious the infection is, other treatments may also be necessary. These can include such things as breathing support, medications to treat low blood pressure, and wound care for parts of the body with damaged skin.

How can Meningococcal disease be prevented?
Vaccination is key. Keeping up to date with the recommended immunizations is the best defense against the disease. Meningococcal vaccine is recommended for all children at age 11-12 years, with a booster at 16 years. Children with certain underlying medical issues, or those who are traveling to certain areas, may need to be vaccinated earlier.

Available vaccines cover most, but not all strains. Even if you have been vaccinated, there is still a chance you can develop a meningococcal infection. People should know the symptoms of meningococcal meningitis and meningococcal septicemia since early recognition and quick medical attention are critical. In addition, maintaining healthy habits, such as getting plenty of rest and not coming into close contact with people who are sick, can help.

For more information, please visit the CDC website at http://www.cdc.gov/meningococcal/about/index.html.

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