By Ronael Eckman, MD
When parents bring their sick children to the doctor, they have a set of expectations for care. Those expectations usually include a thorough examination by medical personnel, a diagnosis of the cause of sickness, a prescription for antibiotics, and of course, for the child to get better in a few days.
However, the use of antibiotics is not always the appropriate or best approach to treat illness. We’ve known for a long time that treating a patient with antibiotics predisposes them to develop future infections that are more resistant to the same antibiotics. This happens frequently with ear infections. In fact, evidence suggests that ear infections in some patients should not be treated with antibiotics at all.
With significant new research and evidence available, we now know there are a variety of situations where the medical community once believed antibiotics helped, when in fact, they don’t help and could actually cause harm. This evidence comes to us through carefully designed and controlled scientific studies that compare improvement with antibiotics, placebos or no treatment at all.
For example, the cough associated with bronchitis and the nasal congestion associated with sinus inflammation/infection is not typically affected by an oral antibiotics. Most of these symptoms are related to infections with viruses and do not respond to antibiotics.
Research also indicates that if a child is treated with antibiotics in the first year of life, the probability of asthma increases. This weighs into any decision to use antibiotics with infants.
In addition, there is an increasing development of “superbugs” resistant to currently available antibiotics. MRSA (methicillin resistant staphylococcus aereus, a bacteria that causes skin, lung and joint/bone infections), is an example that is extremely difficult to treat. Evidence shows that the frequent use of antibiotics, especially when not needed, contributes to the development of this type of resistant bacteria.
As medical professionals, we strive to provide medical care that is consistent with the most current and accurate body of scientific knowledge available. That may conflict with the “traditional” expectation parents have about antibiotics. In fact, treatment with antibiotics may not help at all, and could contribute to long term problems. While we always want our children to feel better quickly, the reality is that sometimes it takes time to heal, and as difficult as this is to accept as parents, when a provider recommends to not use antibiotics, it is based on valid scientific evidence.
Dr. Eckman is a board certified pediatrician who completed her pediatric residency at Phoenix Children’s Hospital in June 2010. A Yavapai County native, she joined Ponderosa Pediatrics in October 2010.
When your child is sick yes we as parents want a fast fix, which in your report you give a reason why we should not use a antibiotic in all cases but when your chid is sick for three weeks with an ear infection and high fever, you never said what you should do. My child has been given antibiotics and is not responding to them. I really don’t know what to do.
Please note that we cannot and will not answer specific medical questions online. That being said, if your child is a patient here, please call us immediately and schedule a same day appointment. Our walk in clinic is also available every morning from 7:45 – 9 a.m.
If not our patient, you need to seek additional treatment for your child. Call your care provider immediately. Children do not always respond to antibiotics and when the symptoms to not go away, further examination is warranted. Remember that your doctor recommends treatment based on extensive education, training and experience with other patients. What works for most children may not work for all. It’s hard to see our children sick and in pain, and it pains us equally. Please go back to your doctor as soon as you can if you are concerned.
Dr. Eckman, thank you! After raising 11 children, many with allergies and sinus/respiratory problems, I am encouraged to see your perspective. When a provider of ours back East recommended we try to drain the ears/sinuses before starting antibiotics, his advice stuck with me and has kept us from over-use of antibiotics. I also studied C-diff as my BSN final project, and am encouraged that you are seeking to prevent the over-prescribing of antibiotics for that reason. So many problems attributed to antibiotic use are not well-known by the public in our quest for quick-fixes.