It’s cold and flu season. And also bronchitis and ear infection season. You have a lot to do, and don’t need to be up all night with sick little kids, or dragging all day because you caught what the Germinators are passing on to the grownups. You just want to feel better. You just want an antibiotic.
In the past, many doctors would give antibiotics even for viral infections. We knew that the antibiotics wouldn’t help the infection but would give the desired placebo effect and along with rest, fluids, and chicken soup, would leave the patient feeling better in 7 to 10 days. But over the past decades, it has become clear that this is not a harmless practice. Here’s why.
1. Antibiotic resistance, otherwise known as superbugs, is rising at an alarming rate. Those scary stories about MRSA suddenly attacking a previously healthy kid who doesn’t respond to any treatment are because of antibiotic resistance. Resistance occurs when bugs are exposed to antibiotics over time, and are able to adapt to them. Repeated inappropriate use of antibiotics trains the bacteria that live in your body and in the environment to resist them, so that when infection does occur, it can’t be defeated.
2. There are very few new antibiotics being developed.
3. The costs of treating viral infections with antibiotics, repeated doctor visits, and unnecessary testing add to the already overburdened health care costs of this country. This is paid for by you, in taxes, premiums, deductibles, and copays. You didn’t think the insurance company was actually paying for any of it did you?
4. Antibiotic use can actually be harmful. The more exposures a person has to a medication, the more risk she has of developing an allergy to it. This then limits the number of medications available to treat actual bacterial infections when they occur. Antibiotics can cause diarrhea in little kids, and yeast infections in women. If you don’t need them, you don’t want to be taking them.
When should you and your kids be getting antibiotics?
Approximately 90% of sore throat in adults is viral. About 30% of sore throat in kids is strep, and this can be confirmed by a rapid strep test. If the test is negative, antibiotics should not be started. The symptoms should improve on their own in 3-4 days. Therefore, if you are an adult, give it 4 days before seeing a doctor, and if you have a child with a sore throat, get the test result before starting antibiotics. Meanwhile, Tylenol, gargling with hot salt water, and ice pops are all good treatments for the symptoms at home.
Bronchitis is an infection of the large airways and consists of a deep, persistent cough, which may produce sputum. Even viral infections can produce green sputum so this isn’t the diagnostic gem we used to think it was. 90% of bronchitis in adults is viral. However, bacterial bronchitis can progress to pneumonia. If you are also short of breath, have a fever greater than 100.4 F, or feel like your heart is racing, these could be signs of something more serious and are worth seeing a doctor for. If your cough lasts more than 3 days, this may also warrant medical attention. People with underlying disease should see a doctor immediately, as should the elderly.
Honey is actually a great remedy for cough, and the American Journal of Pediatrics has publish a study that shows honey is better than over the counter cough syrup in terms of sleeping through the night and reducing episodes of coughing. Just don’t give it to babies or toddlers, because honey may contain spores that immature immune systems can’t resist yet.
Stuffy nose and sinus congestion
Again, about 90% of these symptoms are caused by viruses in adults. If they persist more than 3-4 days, and you have sinus pain, your doctor can assess you to see if antibiotics are needed in your case.
With kids the percentages are similar. You should watch for tenderness or swelling around the eye area or facial pain. These symptoms should be evaluated by your doc.
Cold packs, hot showers and steamy baths, and good old Tylenol are all good short term remedies for the symptoms. A Neti pot may also help relieve the stuffiness and shorten symptoms. Just be careful to wash the Neti pot thoroughly after each use, or you can cause reinfection.
60% of ear infections in kids are bacterial and 40% are viral. It is okay to wait for culture confirmation if your little one isn’t in a lot pain. It is best to have your child seen early for this, however, because untreated bacterial ear infections can cause permanent ear problems. If your child has severe pain, it is also okay to begin antibiotics immediately and you should expect relief after only a couple of doses if it is bacterial.
- Cold or Flu? Don’t Ask for Antibiotics (bu.edu)
- The Danger of Antibiotic Resistance (everydayhealth.com)