Wait and see before taking an antibiotic

Much of the time, illnesses will resolve themselves on their own

I love the holidays, I really do, but every year they seem to occur at precisely the time my kids get sick. Take for example this past Thanksgiving. My son came down with strep throat late in the day Wednesday, hours before school was to break for four days. Panic set in as I contemplated the inevitable in which surely the doctor’s office would be closed for vacation and therefore antibiotics would not be at my disposal.

I didn’t even want to consider a weekend/holiday emergency room visit, which would cost me a $100 co-pay, not to mention time spent in the ER and exposure to more germs. So I did what so many of my mom friends do when a sore throat, fever or ear ache strikes; I got the last doctor appointment of the day in hopes I could start antibiotic treatment right away to stop this ailment from ruining Turkey Day.

Doctors do not just hand out antibiotics when children have a sniffle. In my son’s case a rapid strep test came back negative; however, because his exam indicated a possible infection, I did leave the doctor’s office with a prescription. Several days later, and feeling much better, the positive results were given to me via a lab technician who checked for bacterial growth in a Petri dish. But for the few days in which I was dispensing penicillin I wondered if I was doing the right thing. If my son didn’t really need the medicine after all, was I harming his body instead of helping it?

The role of bacteria

The human body normally coexists with bacteria within the gut, nose and skin. However when you become ill with a bacterial infection you catch by touching an infected surface or via airborne droplets, your white blood cells work hard to attack the harmful bacteria. This is when it becomes appropriate to treat a patient with antibiotics.

According to Dr. Jennifer Jones, a pediatrician with Core Pediatrics in Exeter, the problem arises when normal bacteria spreads and does make people sick, yet it is resistant from overexposure to antibiotics.

“What we see commonly is the MRSA bug which has been routinely exposed to antibiotics. So when someone comes in with an abscess due to a staph infection, it is a resistant organism because the normally occurring bacteria have been overexposed to the medicines meant to treat it,” she said.

“Basically you are taking bugs that used to be innocent and allowing them to build defenses. Normal bacteria will go from innocent bystanders to resistant bugs. The more antibiotics we use more frequently, the more resistant they get. Then we run out of antibiotics that work. Ultimately this could cause people to have fatal infections,” said Dr. Jones.

The purpose of antibiotics

Antibiotics will not work on a common cold or flu, because these are viruses. According to Dr. Jones, a majority of the kids with sore throats, runny noses, colds or coughs have a respiratory infection. And the younger they are the more likely they are to have a virus because they may be in day care or have siblings in school.

So while it can be unsettling to see your child in discomfort, rest assured that getting frequent colds and stomach bugs is the norm. The best remedy for situations like these is simply time and comfort measures to help the little ones fight off the virus.

If you are fairly certain your child has a cold the best advice is to take normal supportive care and comfort measures. Most colds last one to two weeks, however, if they suddenly spike a fever or earache after the onset of a cold, this could indicate an infection. Kids will eventually recover from an infection without antibiotics but antibiotics will reduce the chance of further complications and could shorten the duration.

Here are infections children may experience and when and why it is appropriate to manage care with antibiotics.

Ear Infections

Most mild ear infections will clear completely without antibiotics. The emphasis here is mild. When your child complains of ear pain, and over-the-counter Tylenol relieves symptoms, chances are your child will recover without the use of antibiotics. “Those children with severe infections, which may include high fever, pain, and abnormal exam, will be treated,” said Dr. Jones. “It’s those mild symptoms in which the child is eating and sleeping we like to take the watch and wait approach.”

Sinus Infections

When it comes to sinus infections, antibiotics are usually prescribed for children suffering from persistent and severe symptoms that don’t respond to saline nasal washes and standard care. This is largely due to the 2011 announcement in which the FDA issued a public health warning that over-the-counter (OTC) cough and cold products not be given to kids due to serious side effects.

Strep Throat

Strep throat is always treated to prevent rare complications such as rheumatic fever. But even without treatment the infection will resolve itself within three to five days.

The next time your child comes down with cold symptoms and a sore throat, keep in mind these symptoms will most likely resolve on their own.

“We are so unbelievably lucky we live in a country that has these medicines. But if you are not careful they won’t work as well,” stated Dr. Jones. “We have to remind people the human body is a miraculous thing and our bodies keep us healthy. Sometimes you just need to get out of the way and wait; and let the body heal itself,” she said.

Bridgette Springer is a freelance writer juggling motherhood in Stratham. She is a contributor to regional newspapers, magazines, and marketing projects. Bridgette can be reached at btspringer@comcast.net.