We asked Le Bonheur Pharmacist Kelley Lee, PharmD, to talk about a popular subject this time of year: antibiotics. See what she says about this type of drug below.

All parents hate to see their children suffer during a sore throat, cold or flu.  We’d all like a drug we could use to quickly make our child feel better.  Antibiotics are too often used to provide this relief.  Most minor infections such as colds, flu, coughs, runny nose, most sore throats (excluding strep throat) and some ear infections are caused by viruses.  Although bacteria and viruses are both types of germs that cause diseases in children, antibiotics only work when used for infections caused by bacteria.

Shouldn’t I use an antibiotic “just in case?” There’s no harm in using an antibiotic, is there?

While antibiotics are truly “wonder drugs,” they should only be used when an infection is likely caused by bacteria.  Antibiotics can cause serious side effects.  While most common side effects are mild such as nausea, vomiting, diarrhea and headache, these effects can cause discomfort in all children and may lead to more serious problems in certain children. Not all side effects from antibiotics are mild.  Antibiotics can cause severe diarrhea, blistering rashes, liver and kidney problems and other serious illnesses. 

Most people have heard from the media about “super bugs.”  “Super bugs” are bacteria that have become resistant to commonly used antibiotics.  No antibiotic will get rid of all bacteria.  Every time an antibiotic is taken the bacteria that are sensitive to that antibiotic will be killed, but bacteria that are resistant will remain. This can be a problem for several reasons.  In some people these resistant bacteria may grow and cause other problems like severe diarrhea.  Even if these resistant bacteria don’t cause a problem immediately, they can become more common in the person who has taken the antibiotic, causing the antibiotics not to work next time.  The more antibiotics a person takes, the more likely they will get an infection from resistant bacteria. Resistant bacteria can also be spread to classmates, family and friends. 

If I shouldn’t give antibiotics for these mild childhood infections, what can I do to make my child feel better?

Getting plenty of rest and drinking plenty of fluids are two of the most helpful ways to make your child feel better.  Viral infections will usually go away within seven to 10 days.  Antibiotics will not speed up the process.  Saline nasal sprays or using a humidifier in the child’s bedroom can help stuffy, congested noses.  Breathing steam from a warm shower can also help.  Cough drops (for older children only) or throat sprays can help a sore throat feel better.  Over-the-counter products such as acetaminophen can be used for mild fever or pain, but always read the package or consult with your doctor or pharmacist to be sure the correct dose is used.   The best treatment is prevention:  children older than 6 months of age should get a flu shot each year, and remind children to wash their hands.

How can I help prevent antibiotic resistance?

The best thing parents can do to prevent antibiotic-resistant infections in their children is to only use antibiotics for infections caused by bacteria.  Parents should not ask for a prescription for antibiotics for colds and flu.   When antibiotics are prescribed for an infection caused by bacteria, give your child the entire amount prescribed.  Giving doses that are too small for short lengths of time can cause bacteria to become resistant.

We've posted about this topic before, but thought it was a good time for a reminder. At some time or another, we’re all going to come down with the sniffles, our kids included. Between the runny noses, cough and fevers, it’s tough for parents to know when their child has more than a common cold. But don’t worry. The experts at Le Bonheur Children’s Hospital have tips on identifying and preventing more serious ailments.

Bronchiolitis
Bronchiolitis is an infection caused by a virus typically seen in children 2 years of age and younger. Its symptoms include wheezing, coughing and chest congestion, vomiting and a low-grade fever (less than 101 Fahrenheit). A child may take a longer time to eat with the infection.

The most routine care for bronchiolitis is to treat the symptoms. Parents are encouraged to frequently wash their own hands and their child’s hands, keep their child’s nose cleaned out, encourage their child drink more fluids and control fever. Your child may need medicine for wheezing.

Dr. Barry Gilmore, medical director of Emergency Services at Le Bonheur Children’s, says parents should call or see a doctor if your child has difficulty breathing, is unable to eat or drink or has signs of dehydration. Dehydration signs include dry skin, dry mouth, a lack of tears, and lack of wet diapers or use of the potty.

Le Bonheur Children’s recommends parents seek emergency care if the child’s neck, chest or ribs sink deep when breathing, if the child has trouble breathing or stops breathing, turns blue around the mouth or fingernails, has less than three or four wet diapers per day, or has trouble feeding after suctioning the nose.

Bronchiolitis is caused by a number of different viruses, including respiratory syncytial virus (RSV).

Respiratory Syncytial Virus
RSV is a common winter virus that attacks the lining of the airways and lungs. Dr. John DeVincenzo, a leading investigator in the treatment of RSV, is based at the Children’s Foundation Research Center at Le Bonheur Children’s. He says the virus infects all age groups, but infants younger than 1 year of age are most severely infected. It is the most common cause of pneumonia in infants and the most common cause of hospitalization in infants. In fact, about 3 percent of all babies younger than 1 year of age are hospitalized for RSV infection.

Early signs of RSV infection are the same as a common cold – runny nose, sneezing and mild cough. However, RSV often turns into a deeper cough and causes difficulty breathing by the second or third day of runny nose.

“It is important to try to avoid RSV infections within the first few months of life and avoiding the infection during the entire first winter season of your child’s life would be best,” DeVincenzo said.

For premature babies and for babies with heart or lung problems, medication can help prevent RSV. For other babies, the only way to prevent RSV is to follow these precautions:

From mid-October through the end of March, DeVincenzo recommends that parents try to ensure infants 6 months or younger aren’t touched by adults and children with colds. RSV doesn’t float through the air, but can be sneezed onto your infant or physically brought to your baby by direct physical contact.

Flu
The flu’s peak season runs from late fall through mid-winter and symptoms usually hit hard and fast. Those include fever, headache, muscle aches, dry cough, sore throat and weakness and fatigue. See our recent post on the flu to learn more.