Antibiotics: Handle Them With Care

Antibiotics really are wonder drugs--they have saved countless children's lives over the past century. But many of these medicines are now losing their punch, as disease-causing bacteria learn to resist them. Can parents help stop this insidious process? As it turns out, we can. The surest way to preserve the power of antibiotics is simply to avoid overusing them.

Since antibiotics work only against bacteria, never against viruses, they have no effect on colds, flu, bronchitis and most sore throats. Even kids with deep coughs or green nasal discharge usually have viral infections. These kids don't need antibiotics. They need what moms gave them before antibiotics existed: rest, fluids and time. Antibiotics should enter the picture only when a doctor is reasonably sure that the child has a bacterial infection. Used right, they can speed recovery and prevent complications.

Does your child need an antibiotic? It's not always obvious at first. Some infections, such as strep throat or bacterial pneumonia, should always be treated immediately. In other cases, it may be better to wait a few days rather than treat a virus unnecessarily. Doctors can't always tell whether an ear infection (acute otitis media) is caused by bacteria or a virus, or whether it will get better on its own. In several European countries, many ear infections are treated with pain medicine alone for two or three days, to see if they resolve. Some U.S. physicians are beginning to consider this "watchful waiting" approach, and a just-published study suggests that some parents are willing to go along, using only pain medications initially.

Once the doctor is confident that an infection warrants antibiotic therapy, the challenge is to choose the right medication--the one that is most likely to clear up the infection and least likely to promote antibiotic resistance. Success may require some trial and error. If one antibiotic doesn't control the infection after several days, the doctor may then choose another one. Once your child embarks on a course of antibiotic therapy, be sure to see it through, even if the symptoms subside quickly. Incomplete treatment may cost your child a second round of illness that is much harder to manage.

It's always tempting to seek a quick fix for colds and earaches, but there are better ways to keep your kids safe. Immunizations can prevent many infections, both viral and bacterial. And when someone is sick in your home, you can often protect the rest of the family by minimizing close contact and washing your hands often. Alcohol-based hand gels can be helpful when soap and water aren't available. These preventive measures--cheap, safe and easy--are the best medicine of all.

Finally, there is good news about the use of antibiotics in children. After decades of increase, new studies are showing that the rate of antibiotic use for children has now started to decline. New prescriptions fell by roughly 25 percent between 1995 and 2000. Parents and physicians alike may be getting the message that using these medicines carefully is in everyone's best interest.