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Antibiotics are drugs used to treat infections, and their “combat targets” are bacteria, not viruses. Before using antibiotics, doctors need to make sure it is the right choice for treating children. Parents also need to understand that the wrong use of antibiotics doesn’t work in treatment, but can even cause harm to children.

The American Academy of Pediatrics (AAP) summarizes common questions about children’s use of antibiotics. It is an important guidance for parents to understand the characteristics of infectious diseases and to use antibiotics rationally.

I. My child has a very serious cold. Why does the doctor not give antibiotics?

Colds are caused by viruses, and antibiotics are specially used to treat bacterial infections.

In the general case, the most common cold symptoms (such as runny nose, cough, and stuffy nose) are not as serious as you think. Even if your child does not take any medication, it will gradually get better.

II. Does a cold sometimes develop into a bacterial infection? Why should we not use antibiotics until then?

In most cases, viral infection does not accompany bacterial infections. If you use antibiotics to treat viral infections, it can lead to infections caused by resistant bacteria. In addition, your child may experience diarrhea or other side effects.

If your child has watery diarrhea (stool like water), bloody diarrhea (blood in stool), or other side effects when taking antibiotics, contact a doctor right away.

III. Does a child’s yellow or green nose be a sign of bacterial infection?

When suffering from a common cold, the child’s nose becomes thick and it is normal to change from transparent to yellow or green. These symptoms usually last 10 days.

Sinusitis refers to inflammation that occurs at the nasal mucosa and sinuses (cranial cavity around the nasal cavity). Viruses or allergies can cause sinusitis, and in some cases, bacteria can also.

The following symptoms may indicate that bacteria have been involved in your child’s respiratory disease. If your child has a common cold and has had a cough and runny nose for more than 10 days, or if the child has a thick yellow or green nose and high fever (temperature above 39°C) continues for at least 3 to 4 days, This is a sign that a child may have bacterial sinusitis.

If your child has bacterial sinusitis (which is uncommon), doctors may use antibiotics for treatment. Before the prescription is opened, the doctor will ask the child’s other symptoms in detail and give the child a detailed examination to ensure that the use of antibiotics is the right choice.

IV. Should antibiotics not be used to treat ear infections?

Not all ear infections must be treated with antibiotics. At least half of ear infections will also heal without antibiotic treatment. If your child does not have a high fever or severe ear pain, the doctor may usually recommend initial observations.

Pain is often the first symptom of an ear infection and it is also the most unpleasant. Doctors often recommend the use of pain relievers to relieve the child’s pain. Both acetaminophen and ibuprofen are over-the-counter pain medications that can effectively reduce pain. When taking medicine, it is necessary to use the right dose according to the child’s age and weight. In most cases, pain and fever will be relieved within 1 to 2 days.

There are drops of medicine on the market that help to relieve ear pain temporarily. Ask your doctor if your child is suitable for these medicines. Over-the-counter cold medicines (relief of nasal congestion and allergy symptoms) do not treat ear infections and therefore are not recommended for children.

If the child develops persistent fever, increased ear pain or otitis media (intratympanic infection), the doctor may use antibiotics for treatment.

V. Is antibiotics not supposed to treat sore throats?

More than 80% of sore throats are caused by viruses. If your child has symptoms of sore throat, runny nose, and cough (coughing sounds like a dog’s barking), it is mostly caused by a virus. Therefore, children do not have to be checked for streptococci at all.

Antibiotics are limited to the treatment of sore throat caused by group A streptococcus. Infections caused by such bacteria are called “septic pharyngitis.” This bacterial infection is common in school-aged children and usually does not cause illness in children under 3 years of age.

If the doctor suspects that the child has stinging pharyngitis based on symptoms, streptococcal examinations are usually performed. If the test is positive, the doctor will use antibiotics for treatment.

VI. Can antibiotics cause side effects?

Of every 10 children taking antibiotics, there may be one child with side effects. Side effects usually include rashes (red or raised skin), allergic reactions, nausea, diarrhea, and abdominal pain. If your child had previous experience of adverse reactions due to taking antibiotics, please inform the doctor in advance.

Sometimes children develop rashes when taking antibiotics. However, not all skin rashes are allergic reactions. If you notice that your child has urticaria (a swelling of the skin in your area), this may be a drug-induced allergic reaction. Please inform your doctor immediately. If your child has a itch or urticaria that causes itching because of a drug allergy, it should be recorded in the medical record.

VII. How long does it take for antibiotics to work?

Within 48 to 72 hours of starting antibiotics, most bacterial infections are controlled and improved. If the child’s symptoms become more severe or do not improve within 72 hours, please inform the doctor. If the child stops antibiotics prematurely, the infection may not be completely treated and the symptoms may reappear.

VIII. Can antibiotics cause drug-resistant bacteria?

Repeated use and abuse of antibiotics can lead to the emergence of resistant bacteria. Resistant bacteria are bacteria that are not killed by common antibiotics. Resistant bacteria can be transmitted to other children and adults.

It is very important for children to use antibiotics that are most suitable for the infection rather than broad-spectrum antibiotics (which can treat multiple bacterial infections).

If the child does have a drug-resistant infection, a special type of antibiotic may be needed for treatment. Sometimes these drugs require intravenous drip (infusion).

IX. What is an antiviral drug?

Influenza (flu) is a viral infection that causes cold symptoms. If the child has the flu and the condition is highly likely to worsen, the doctor will use antiviral drugs for treatment. For most other viruses that cause symptoms of cough and cold, antiviral drugs are not recommended for treatment.

X. How can I safely use antibiotics for my child?

When the child is ill, it is not always right to rush to take antibiotics. Please be sure to consult your doctor for the best treatment.

Ask the doctor if the antibiotics he uses are specific to the type of bacteria the child is infected with. Because some antibiotics (such as azithromycin) are no longer effective against most bacterial ear and sinus infections.

Antibiotics can only treat bacterial infections and are not effective against colds and flu.

Make sure to follow your doctor’s instructions or medication instructions.

Do not use your child’s leftover antibiotics for other children. This may lead to misuse and danger.

Throw away unused antibiotics and do not stock antibiotics at home.

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