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.

Parents will soon see big changes to their usual over-the-counter (OTC) pediatric pain relievers. The makers of many store-brand acetaminophen drugs say they will standardize dosing for children and infants in an effort to improve the safety of the products.

The decision to implement these changes is based on research and recent reports of accidental overdoses in children, according to the Food and Drug Administration. In several cases of overdose, liquid infant acetaminophen drops were mistaken for the children’s version of the pain killer.

The children and infant versions of OTC pain killers differ in their acetaminophen dosages, says Le Bonheur Children’s Hospital Pharmacist Kelley Lee. One teaspoonful of the infant drops contains 500 mg of acetaminophen, where one teaspoonful of the children's product contains only 160 mg.

“Confusing the two products will result in a very large difference in the dose,” says Lee. “When acetaminophen is given in larger doses than intended it can cause great harm to the child.”

By creating one formula, drugmakers hope to eliminate the dosage confusion.

Also in an effort to reduce dosing errors, the products will feature a new dosing device – a syringe, instead of a dropper. The new formula will also be free of high fructose corn syrup and dye, based on the preference of most mothers as reflected in the drug companies’ research.

These products are scheduled to hit the market in September. Until then, parents and caregivers should be particularly careful when a physician or pharmacist has recommended a dose for their child, says Lee.

“Parents should be sure they understand which version – infant or child – the clinician has based the recommended dose on,” she said. “If no dose is recommended, the parent should always read the product label and never give more than is stated for their child’s age or weight.”

Always double check the label, even if you’ve given your child acetaminophen in the past.