Not all adults know how to take antibiotics correctly. Some believe that this medicine is from all the hurts, especially those that are more serious. Others, on the contrary, avoid antibiotics in every possible way because of their toxicity. The third will risk taking a “magic pill”, if the doctor prescribes, but pregnant women and children in every possible way will dissuade from antibiotic therapy.
Who is really right? And what antibiotics are acceptable for children? And maybe they have a very safe alternative?
Principles of prescribing antibiotics for children
The use of antibiotics by such vulnerable categories of persons as pregnant or young children differs somewhat from the same therapy for the rest of the population. All the features are reduced to how antibiotics can affect only the nascent organism during pregnancy, how it will affect its course, and also how they affect the developing, fragile organism of a small child, for example, on its liver.
When prescribing antibiotics, like many other categories of medicines, the doctor should take into account the potential benefits and the likely risk of taking the medication. Only by comparing such expectations, the professional makes a decision – to treat with an antibiotic or alternative means. This applies to both children and adults.
What is the benefit and harm of antibiotics?
The invention of this category of medicines in the middle of the last century made a revolutionary breakthrough in medicine without exaggeration. One name indicates that these drugs with pronounced antibacterial properties. Thanks to antibiotics, in a short time mankind managed to take control of a lot of bacterial epidemics, and until now many of these drugs have no alternative.
With specific diseases of bacterial etiology, antibiotics can not be abandoned – neither for children nor for adults. Such an unequivocal success can not be achieved with respect to viral diseases.
Undoubtedly, many antiviral agents have been developed by doctors (the simplest thing that comes to mind – from influenza and ARVI), but until now the same HIV is irresistible. With whatever disease you have to face, it is important to understand that viral diseases must be treated with antiviral drugs, and bacterial ones by those same antibiotics. Often, viruses create the prerequisites for bacterial infection, or the symptoms of viral infections are confused with bacterial symptoms. Just to choose the right medicine – for a child, an adult, a pregnant woman, and an old man – a medical consultation is needed, and probably laboratory, instrumental diagnostics. In other words, independent choice of antibiotics for children is unacceptable – neither on the basis of past experience, nor on the basis of analysis of symptoms by parents, nor on the basis of someone’s advice.
After examining the child, the pediatrician can not always draw conclusions about the nature of the disease. Unfortunately, when it comes to respiratory infections, it is not uncommon for both instrumental and laboratory diagnostics to be sufficient to indicate the type of pathogen. Then physicians will have to rely on their own experience and on the clinical characteristics of a particular case. In accordance with this, rhinitis and bronchitis (at an early stage) are explained by the virus origin, and the sinusitis and pneumonia are bacterial. The same can be said about angina with otitis.
In the appointment of antibiotics for children, the pediatrician certainly follows two basic principles:
- rapid appointment of the most effective drugs in cases where their effect is proven;
- the maximum reduction in the use of antibacterial drugs in all other cases.
A professional medic antibiotics for children will be appointed only in the case when one can not do without them. And the potential benefit of the drug (in particular its medicamentous effect on the pathogen) exceeds the probable harm (for example, a violation of the intestinal microflora or a weakening effect on the liver). When a pediatrician prescribes antibiotics for children, he also determines the dosage, the frequency of treatment and the duration of the course of treatment. Parents are not strictly forbidden to violate his recommendations, since this is how a drug resistance can develop in a person from a young age, which means that in the future (if the need arises again), it will not be so effective if it is not useless at all.
In the treatment of common childhood diseases, parents should carefully listen to pediatrician’s advice and do not exert pressure on him about the most optimal method of treatment.
- It often happens that parents at their own risk and risk prefer to treat otitis or bronchitis with folk remedies, or give preference to an antiviral agent, because it helped their friends. This is fundamentally wrong. The treatment strategy for both children and adults should be made individually. And if in a particular case the doctor prescribes an antibiotic, dear parents, try to discuss and understand why and why.
- There is another category of parents. Who are so worried about their kids and who are so unbearably watching his illness, that in antibiotics for children they see a quick solution to all problems. Such zealous followers of a quick recovery can only harm their perseverance. A lot of doctors will agree to prescribe a child an antibiotic without the need, just not to drop their reputation in the eyes of their parents.
In a hospital with severe and life-threatening infectious diseases, the responsibility for the correct choice of a medicine lies entirely with the physician, which is based on patient observation data and on the results of special studies.
Indications for use of antibiotics by children
The appointment of antibiotics for children should be handled exclusively by a professional pediatrician – on the basis of an anamnesis of the disease, patient complaints (observations of his parents), results of laboratory or instrumental diagnostics.
Indications for the use of antibiotics for children are divided into relative and absolute:
- severe forms of acute respiratory diseases – there is usually no opportunity to exclude participation in the process of pathogenic bacterial flora;
- acute moderate respiratory infections – if there are foci of chronic infection, mycoplasma infection, suspicion of a bacterial flora and a high risk of complications;
- infections of the upper and lower respiratory tract (acute purulent sinusitis, streptococcal tonsillitis, pneumonia, diphtheria, scarlet fever, etc.);
- acute otitis media in children of the 1st and 2nd year of life;
- urinary tract infection (pyelonephritis, cystitis, etc.);
- other localization of bacterial flora (meningitis, poliomyelitis and others).
When antibiotics are not needed for children?
Despite the fact that the benefits of antibiotics are undeniable and often irreplaceable, there are conditions in which their admission to both children and adults is completely inappropriate:
- viral diseases – it’s influenza, and other ARVI, and some cases of bronchitis, and other viral diseases; antibiotics are effective only against bacteria and have no effect on the viral flora;
- fever – if the baby’s body temperature increases, then this is not a reason for using antibiotics; this category of medicines does not have antipyretic, analgesic, or anti-inflammatory effect, but exclusively antibacterial; at the same time neutralization of the bacterial flora and leads to the above effects, but only if the symptoms are caused precisely by bacteria;
- intestinal infections – acute intestinal infections in children accompanied by watery diarrhea are not treated with antibiotics; It is strongly recommended that a specialist be consulted;
- prevention of bacterial complications – often against the background of a viral disease develops bacterial, for example, a cold or SARS in a few days can develop into bacterial bronchitis, or otitis, or even pneumonia; but giving antibiotics to children for prevention is not only useless, but also harmful, since so too does bacterial resistance develop.
The main contraindication to the use of antibiotics by children, which is most often disturbed, are ARVI. Respiratory viral infections can develop into a bacterial infection in a short time. Even though it is still a viral nature, malaise of the airways can be confused with bacterial diseases – this is susceptible to both parents and doctors. For example, it is very difficult to determine the nature of infection in infants, and in very young children the attachment of a bacterial infection occurs in the overwhelming number of cases already on the third day. As already noted, antibiotics are not prescribed for children in the course of prophylaxis, however, if the symptoms do not subside by the third day, a pathogenic bacterial flora has a 99% probability. This is indicated by such symptoms of complicated ARVI:
- temperature 38°C at the age of up to 3 months and 39°C at the age of up to 3 years for 3 days or more;
- after the improvement of the condition a few days after the onset of the indisposition on the 5th-6th day, the symptomatology returns and is further aggravated;
- enlarged lymph nodes on the neck;
- prolonged cough more than 10-14 days – there is a risk of pertussis;
- purulent discharge from the nasal passages – there is a risk of genyantritis;
- white or purulent coating on the glands – it can be both sore throat and scarlet fever, diphtheria, mononucleosis.
The above symptoms automatically transfer acute respiratory diseases from the category of contraindications, to the category of indications for the use of antibiotics. In severe forms of acute respiratory disease, antibiotics are prescribed at the discretion of the physician, since the exclusion of the bacterial flora in the pathological process is not excluded.