Ask a Pediatrician: Don’t be so quick to request — or prescribe — antiobiotics – LancasterOnline

Question: I took my 10-year-old child to see our pediatrician for a sore throat. He did the throat swab and it was negative for strep, so we got sent home to wait and see if it gets better. In the past we have had to come back a couple of days later, and then it was strep or a sinus infection. I do not understand why the doctor didn’t just put him on antibiotics as a preventative?

Answer: This scenario is incredibly frustrating, both for parents and health-care providers. It puts them at odds with each other, and it comes down to communication.

When it comes to sickness, parents have one goal: restoring their child back to health as quickly as possible. Health-care providers share this goal but we have a few other factors to balance into the equation, such as avoiding side effects and antibiotic resistance.

The rapid strep test performed in doctor’s offices is very sensitive, if done correctly, the test comes with a 95 percent or higher accuracy rate. So it is safe to rely on these results and not prescribe antibiotics. Only about 20 percent of all sore throats are caused by bacteria; most of them are viral and will not respond to antibiotics.

There were over 2 million illnesses last year caused by antibiotic resistance. The best way to combat this growing problem is to stop using antibiotics when they are not needed. Based on recent statistics, only 2 percent of viral infections lead to bacterial complications such as sinusitis. Placing someone on an antibiotic to prevent something that probably won’t happen is not good medicine.

When a person is on antibiotics, any bacteria living in the body, both good and bad, will be killed. However, any resistant bacteria that may be lingering will survive and can replicate quickly in the absence of other bacteria fighting for resources. This builds upon itself with each exposure to antibiotics, and places the person at increased risk for disease caused by resistant bacteria.

In addition to resistance, your provider is likely considering the risks of side effects from antibiotics. Allergic reactions, rashes, yeast infections, diarrhea and abdominal pain are only a few of the possible reactions that occur quite commonly with antibiotics. These are all worth the risk if the antibiotic is needed for a true bacterial infection, but they become liabilities if the medication is not needed

Antibiotics are the most common cause of emergency department visits for adverse drug events in children, with the bulk of these being for an allergic reaction. Physicians must follow their Hippocratic Oath: First Do No Harm — and a nonessential antibiotic could lead to harm.

Sometimes it seems like health-care providers and parents are in opposition when it comes to the need for antibiotics, but it does not have to be that way. Statistics suggest that up to 50 percent of all antibiotic prescriptions are inappropriately prescribed. Health care providers are changing their habits, and you can help facilitate this change.

Remember the following four tips when you feel the urge to ask for an antibiotic:

  • Be reassured that your provider has checked your child and he or she is not in danger.
  • Most viral infections will go away with proper rest and hydration, but it may take seven to 10 days.
  • Call your provider with any new or worsening symptoms, persistent fevers or pain.
  • Place value in the importance of combating antibiotic resistance.

Studies suggest that parental request for an antibiotic frequently sways a health-care provider’s prescribing habits. So try not to put your provider in that situation unless you feel very strongly that an antibiotic is warranted. If a health-care provider does prescribe antibiotics for your child, make sure you understand exactly what it is for and how it should be taken. If the need for the antibiotic is not certain, consider asking your provider if he or she is comfortable if you observe your child for a few days before starting it. Reassure them that you will call with any change in symptoms.

We all want that magic medication that will make our kids instantly feel better when they are sick. But for most illnesses, that medicine doesn’t exist. Antibiotics can be life-saving medications, but they do not treat viral infections such as the common cold. Providers and parents need to communicate and trust that everyone has the same goal: a healthy child growing into a healthy adult.

  • Dr. Pia Fenimore, of Lancaster Pediatric Associates, answers questions about children’s health. You can submit questions at Features@LNPnews.com.

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