Jessica and Tim Lahey have a teenager who has never needed an antibiotic.  Still, they worry about what will happen if he needs one:

In the short term, harm is admittedly uncommonAntibiotics can give kids rashes, nausea, and in some cases a life-threatening antibiotic-related infection called C. diff.

In the long run, though, the harm is huge, and partially hidden. As a society, we hand out antibiotics like candy, tossing one life preserver here, one there, assuming the supply is never ending. But it turns out we are, in fact, running out of antibiotics. This will in turn affect our son, who has never taken an antibiotic in his life.


The Laheys are concerned that people — especially children — are getting too many antibiotics too frequently:

Every year, more and more children with viral illnesses are given unnecessary antibiotics, and as a result, the bacteria floating around in our bodies get exposed to those antibiotics and evolve, gaining resistance to even our most powerful antibiotics. Reports of these drug resistant bacteria are increasingly alarming.


The CDC is warning today of the emergence of a particularly dangerous bacteria that has become resistant to almost every antibiotic.  Mike Stobbe says the infections they cause are hospital-acquired:

Health officials call them “nightmare bacteria” that have now been seen in 42 states and threaten to spread their resistance to more and more of their bacterial brethren.

“We only have a limited window of opportunity to stop spread” of these superbugs, said CDC Director Dr. Tom Frieden. At a press conference Tuesday, he said he was “sounding an alarm.”

The CDC urged hospital workers to watch for the infections and take steps to prevent passing the germs to other patients.

The report did not include better-known superbugs like the staph infection MRSA or the intestinal bug known as C. diff, which have plagued hospitals.

It focused on the superbugs that have emerged from one specific bacteria group. At least five of the 70 kinds in that family have developed resistance to a class of antibiotic called carbapenems – considered one of the last lines of defense against hard-to-treat bugs.


The Laheys hit the nail:

Here are five facts you can use to protect everyone from what has been called the “antibiotic apocalypse:”


  • Antibiotics are unnecessary for colds or bronchitis, even when they last longer than two weeks.Colds and bronchitis often take more than two weeks to resolve, so if there are no signs of pneumonia, then antibiotics can be withheld safely.
  • Green sinus discharge and green sputum does not mean you require antibiotics. Sinus discharge, sputum, and phlegm all turn various colors as the body fights infection, and many studies have shown that green sputum is as likely to be viral as bacterial.
  • Ear and sinus infections don’t always require antibiotics. Medical guidelines for sinus and (hot off the presses) ear infections suggest that patients without red flag symptoms can be observed without antibiotics; your doctor can help ensure this is safe.
  • If your child gets a prescription for antibiotics, ask your doctor to explain why.
  • The diagnosis of pneumonia — a legitimate indication for antibiotics — can not be made without a chest X-ray. Since the symptoms and physical examination can be the same in bronchitis (which is usually caused by a virus) and pneumonia (often bacterial), a chest X-ray is needed to determine if the diagnosis is really pneumonia, and therefore if antibiotics are needed. Don’t accept a prescription for antibiotics for pneumonia without a chest x-ray.


All great points — except the last, which is mistaken and misguided.  Diagnosing pneumonia can often be done without a chest x-ray.  If a physician has a healthy level of suspicion, a sick patient who can take deep breaths, and a stethoscope, the diagnosis can be made without the exposure to radiation, cost, and inconvenience of an x-ray.  While it may be difficult to know whether the pneumonia is caused by a virus or a bacteria (that’s a guess), saying that you need to get an x-ray to call it pneumonia in the first place is ludicrous!  If a child looks like he has pneumonia and sounds like he has pneumonia, a well-trained and experienced pediatrician does not need a picture to conclude that the child has pneumonia!

I think parents and physicians should focus on the advice the Lahey’s give before that:

If your child gets a prescription for antibiotics, ask your doctor to explain why.


Read Jessica and Tim Lahey’s article here.