As World Antibiotic Awareness Week comes to a close, the U.S. Centers for Disease Control and Prevention addresses the global public health threat of antimicrobial resistance as an American problem, too:

U.S. Antibiotic Awareness Week is an annual one-week observance to raise awareness of antibiotic resistance and the importance of appropriate antibiotic prescribing and use.

Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result of these infections. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.

The use of antibiotics is the single most important factor leading to antibiotic resistance around the world. Antibiotics are among the most commonly prescribed drugs used in human medicine. However, up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. Antibiotics are also commonly used for promoting growth in food animals, one type of use that is not necessary.

 

Yesterday we noted that everyone has a role to play in confronting what, you would have to argue, is a grim prognosis. The American Academy of Pediatrics has prepared a list of common questions surrounding the typical use of antibiotics that most parents will find helpful. This is a common question pediatricians get asked:

My child has a really bad cold. Why won’t the doctor prescribe an antibiotic?

Colds are caused by viruses. Antibiotics are used specifically for infections caused by bacteria. In general, most common cold symptoms—such as runny nose, cough, and congestion—are mild and your child will get better without using any medicines.

 

Parental impatience with colds and viral flus taking their own sweet time to resolve is perfectly understandable:

Don’t some colds turn into bacterial infections? So why wait to start an antibiotic?

In most cases, bacterial infections do not follow viral infections. Using antibiotics to treat viral infections may instead lead to an infection caused by resistant bacteria. Also, your child may develop diarrhea or other side effects. If your child develops watery diarrhea, diarrhea with blood in it, or other side effects while taking an antibiotic, call your child’s doctor.

 

Some infections require antibiotics and others don’t. For example, acute bacterial sinus infections are not as common as we once thought. Most are just bad colds:

Isn’t a nose draining yellow or green mucus a sign of a bacterial infection?

During a common cold, it is normal for mucus from the nose to get thick and to change from clear to yellow or green. Symptoms often last for 10 days.

Sinusitis is a term that means inflammation of the lining of the nose and sinuses. A virus or allergy can cause sinusitis and in some cases, bacteria can be the cause.

There are certain signs that bacteria may be involved in your child’s respiratory illness. If your child has a common cold with cough and green mucus that lasts longer than 10 days, or if your child has thick yellow or green mucus and a feverhigher than 102°F (39°C) for at least 3 or 4 days, this may be a sign of bacterial sinusitis.

If your child has developed bacterial sinusitis (which is uncommon), an antibiotic may be needed. Before an antibiotic is prescribed, your child’s doctor will ask about other signs and examine your child to make sure an antibiotic is the right medicine.

 

How about ear infections?

Aren’t antibiotics supposed to treat ear infections?

Not all ear infections are treated with antibiotics. At least half of all ear infections go away without antibiotics. If your child does not have a high fever or severe ear pain, your child’s doctor may recommend observation initially.

Because pain is often the first and most uncomfortable symptom of ear infection, your child’s doctor will suggest pain medicine to ease your child’s pain. Acetaminophen and ibuprofen are over-the-counter pain medicines that may help lessen much of the pain. Be sure to use the right dose for your child’s age and size. In most cases, pain and fever will improve within the first 1 to 2 days.

There are also ear drops that may help ear pain for a short time. You can ask your child’s doctor if your child should use these drops. Over-the-counter cold medicines (decongestants and antihistamines) don’t help clear up ear infections and are not recommended for young children.

Your child’s doctor may prescribe antibiotics if your child has fever that is increasing, more severe ear pain, and infection in both eardrums.

 

One more question from the AAP with an answer that should echo your pediatrician:

Aren’t antibiotics used to treat all sore throats?

​​No. More than 80% of sore throats are caused by a virus. If your child has sore throat, runny nose, and a barky cough, a virus is the likely cause and a test for “strep” is not needed and should not be performed.

Antibiotics should only be used to treat sore throats caused by group A streptococci. Infection caused by this type of bacteria is called “strep throat.” Strep throat generally affects school-aged children and not children younger than 3 years.

If your child’s doctor suspects strep throat based on your child’s symptoms, a strep test should always be performed. If the test is positive, antibiotics will be prescribed.

 

You can read the other questions and answers regarding antibiotic prescriptions for children here at the AAP’s informative website healthychildren.org.