This is something I hear very often at my Clinic. In the present day scenario, where both parents are working, a child coming down with fever can result in adding to the stress factor and causing anxiety to the family. This often results in parents resorting to administering antibiotics to the child hoping for a quick recovery. However, self-administration of antibiotics can actually do more harm than benefit to the child.
Most fevers, coughs and colds are caused by viral infections, which are self-limiting, and do not need antibiotics. However, if these symptoms are due to bacterial infections, then the line of treatment is the correct antibiotic as prescribed by the attending paediatrician. Unnecessary and extended intake of antibiotics has an adverse impact on the child’s immunity and also could result in other side-effects.
As a paediatrician, I prefer to determine the likelihood of a bacterial infection, weigh the benefits versus harms of antibiotics and then implement prescribing strategies, with considerations given to watchful waiting if appropriate.
In my clinical experience of nearly 20 years, eight of which were in the US, I have observed that parents do understand when asked to wait and watch if the fever is viral. Majority of pediatric infections like upper airway infections, stomach infections, some skin and throat infections are viral. Once a viral infection is clinically confirmed I educate parents about child’s own immune system and its ability to fight the infection without antibiotics. Our job as paediatrician and parent is to make the child comfortable by prescribing medication to relieve the symptoms but no antibiotics are required at this stage. Most important way to stop the spread of viral infection is to wash hands frequently, and avoiding close contact with a sick child; hence we should not send a sick child to school.
Since viral and bacterial infection symptoms are almost similar it is of utmost importance that parents consult a paediatrician who may advise some diagnostic tests, if necessary, to determine whether the fever is due to viral or bacterial infection. During my practice in the US, the availability of rapid diagnostics tests like rapid strep tests (for throat infections) and rapid flu test (for influenza) made it convenient to diagnose and differentiate quickly while the patient waited at the clinic. These tests are still not available in India.
Another practice, widely prevalent in India, is seeking the advice from the local pharmacists and starting on medication without consulting a paediatrician. This may often result in a quick relief and parents can continue with their work, the child may be temporarily well enough to attend school. But think for a moment, the long-term harm this may do to the child. When the child actually needs the antibiotic, the body may have developed resistance to the drug and the paediatrician may be compelled to prescribe a higher level antibiotics.
This indiscriminate and unnecessary administration of antibiotics is causing worldwide concern. Bacteria that would ordinarily respond to routine antibiotics are now becoming resistant. As this is happening patients are getting exposed to higher dosages and more expensive drugs which also require intravenous administration, sometimes even hospitalization.
The emergence of superbugs (resistant bacteria) is happening much faster than the invention of new super antibiotics. So, before your child runs out of antibiotics, please limit their use!