The One About Antibiotics

“My child’s friend has the same symptoms, and he is getting antibiotics.  Why doesn’t my son get them, doesn’t he need an antibiotic to get better?” 

I’ve heard this question asked many times in many ways.  Often underlying this or similar questions is the expectation that when you are sick and go to the doctor, they give you a prescription that will make you better.  This expectation doesn’t necessarily mirror reality.  Pediatricians and other primary care doctors very often see people for things that are not made better by prescription medications, antibiotics or otherwise.  We often spend more time discussing ways to care for the symptoms of a viral illness than we would writing a prescription to treat a straightforward bacterial infection like strep throat.

So, let’s get a clear understanding of what antibiotics do and what they don’t do.

What Antibiotics Do

Medically speaking, the term “antibiotic” actually refers to any antimicrobial.  This includes antibacterials, antivirals, and antifungals.   However, most people are referring to antibacterials when they use the term antibiotics.

Antibiotics (antibacterials) kill bacteria.  That’s it, plain and simple.  They work by a variety of mechanisms to either kill bacteria or stop their growth so that your body’s immune system can take care of the rest.

Here’s what antibiotics DO NOT do:

  • Antibiotics do not kill viruses
  • They do not help directly with pain (they may get rid of the source of pain, and therefore help indirectly)
  • They do not get rid of mucous in the nose or make fluid drain from the ears.

But, they do kill bacteria!  They do treat bacterial infections and they do save lives.

Therefore, the question should be “Does my child have a bacterial infection that will benefit from antibiotics?”

When there is evidence that a child has a bacterial infection, the use of antibiotics is appropriate and often necessary for recovery.  Therefore, patients are urged to finish the course of antibiotics as it has been prescribed.  If there is no evidence of bacterial infection, antibiotics are (usually) not so great tasting liquids that have side effects and won’t help your child.

So, your child’s friend is on an antibiotic and your child is not.  This is usually a good thing!  Assuming the friend saw a doctor who prescribes antibiotics appropriately and responsibly, the friend must have evidence of bacterial illness.  Maybe on top of a cold they have evidence of pneumonia or an ear infection.  Celebrate that your child has not developed such infections!  Do your best to do things that help your child feel better and allow plenty of rest for the body to recover.  And, if your child is getting worse or doesn’t seem to be recovering in the expected time frame, bring your child back to the pediatrician to make sure that there is not additional treatment needed.

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