Tweet
Overuse of antibiotics leaves children open to infection
Overuse of antibiotics leaves children open to infection
<!-- /Summary -->The overuse and inappropriate use of antibiotics has led to antibiotic resistance, prompting agencies such as the U.S. Centers for Disease Control and Prevention to call the situation one of the "world's most pressing public health problems."
Because of the widespread and inappropriate use of these medications, we have seen the rampant increase of bacteria that have become immune to the most common antibiotics that we prescribe to fight infections. When an antibiotic is used unnecessarily, the germs learn how to become resistant to it, rendering the drugs useless against them. Of particular concern is the pediatric population. Kids have the highest rate of antibiotic use. And, not surprisingly, they also have the highest rate of illnesses that are caused by these resistant bugs.
A recent study in the British Medical Journal highlighted that antibiotics should not be given to a patient with runny nose and coloured discharge. When nasal discharge is green, it often acts as a catalyst for the doctor to prescribe an antibiotic. (Many doctors think that a green or yellow nasal discharge is a sign of a bacterial infection. But this is not necessarily the case.) The study showed that for every seven patients who get antibiotics in this clinical situation, six will not receive any benefit at all.
Even worse, some studies show that for every 15 patients treated, 14 will get no benefit and only one will be improved by the use of antibiotics. Possible side effects of antibiotics can include vomiting, diarrhea, stomach upset, rashes and even hyperactivity. The study found that most patients will get better without the prescription medication.
A recent study in the September issue of the Journal of the American Medical Association looked at a different way of dealing with ear infections called the "WASP" approach -- which stands for "wait-and-see prescription." Ear infections, also known as otitis media, represent the most common acute infectious illness for which doctors offer antibiotic treatment.
In the study, 283 children with acute ear infections between the ages of six months and 12 years of age were randomly assigned to one of two treatment groups. One group received the standard antibiotic therapy while the other half were given the wait-and-see prescription and told only to fill it if the child got steadily worse.
All children in both treatment groups got ibuprofen and ear drops to use at home for pain management if needed. The study found that for patients in the WASP group, 62 per cent did not fill the prescription. In the standard treatment group, just 13 per cent did not fill the prescription.
Yet there was no real difference between the groups when it came to subsequent fever, ear ache or unscheduled visits for medical care.
The study showed that the wait-and-see approach significantly decreased the use of antibiotics, reducing the risk of antibiotic resistance. While it is critical to treat those children at risk for worsening outcomes, it is reasonable to consider delaying the use of an antibiotic when the child is not terribly ill or the prescribing physician feels it is reasonable to adopt this approach. For infants younger than six months, or for those who appear sicker, antibiotics might be used without waiting.
It is important to remember that antibiotics aren't useful in treating viral infections.
They're not required for colds, flu, chest cold in otherwise healthy children and adults, sore throats (with the exception of those caused by strep bacteria), many cases of bronchitis in otherwise healthy adults and children, and many ear infections.
If your doctor does not feel an antibiotic is required, do not demand it -- it will not help treat the infection or make you feel better faster. If you are given an antibiotic, remember to take all the doses. Don't save any for "the next time" and never take anyone else's prescription antibiotics.
Have a conversation with your physician about what signs to look out for that might indicate an infection is getting worse and might need a medication to bring it under control.
For example, with a chest infection that causes wheezing, an inhaler might be used. You should also be given clear information about when reassessment is required.
Together, by using medication in an appropriate fashion, we will all benefit as a community and decrease antibiotic resistance.
DR. MARLA SHAPIRO
As the weather gets colder, we know that the inevitable season of colds and flu illnesses in our kids is likely to peak. With close crowding, shared toys and overheated environments, it is easy for germs to spread from one child to another. Along with those infectious diseases comes a visit to your doctor or walk-in clinic. All too often, an antibiotic is prescribed when it might not be required.<!-- /Summary -->The overuse and inappropriate use of antibiotics has led to antibiotic resistance, prompting agencies such as the U.S. Centers for Disease Control and Prevention to call the situation one of the "world's most pressing public health problems."
Because of the widespread and inappropriate use of these medications, we have seen the rampant increase of bacteria that have become immune to the most common antibiotics that we prescribe to fight infections. When an antibiotic is used unnecessarily, the germs learn how to become resistant to it, rendering the drugs useless against them. Of particular concern is the pediatric population. Kids have the highest rate of antibiotic use. And, not surprisingly, they also have the highest rate of illnesses that are caused by these resistant bugs.
A recent study in the British Medical Journal highlighted that antibiotics should not be given to a patient with runny nose and coloured discharge. When nasal discharge is green, it often acts as a catalyst for the doctor to prescribe an antibiotic. (Many doctors think that a green or yellow nasal discharge is a sign of a bacterial infection. But this is not necessarily the case.) The study showed that for every seven patients who get antibiotics in this clinical situation, six will not receive any benefit at all.
Even worse, some studies show that for every 15 patients treated, 14 will get no benefit and only one will be improved by the use of antibiotics. Possible side effects of antibiotics can include vomiting, diarrhea, stomach upset, rashes and even hyperactivity. The study found that most patients will get better without the prescription medication.
A recent study in the September issue of the Journal of the American Medical Association looked at a different way of dealing with ear infections called the "WASP" approach -- which stands for "wait-and-see prescription." Ear infections, also known as otitis media, represent the most common acute infectious illness for which doctors offer antibiotic treatment.
In the study, 283 children with acute ear infections between the ages of six months and 12 years of age were randomly assigned to one of two treatment groups. One group received the standard antibiotic therapy while the other half were given the wait-and-see prescription and told only to fill it if the child got steadily worse.
All children in both treatment groups got ibuprofen and ear drops to use at home for pain management if needed. The study found that for patients in the WASP group, 62 per cent did not fill the prescription. In the standard treatment group, just 13 per cent did not fill the prescription.
Yet there was no real difference between the groups when it came to subsequent fever, ear ache or unscheduled visits for medical care.
The study showed that the wait-and-see approach significantly decreased the use of antibiotics, reducing the risk of antibiotic resistance. While it is critical to treat those children at risk for worsening outcomes, it is reasonable to consider delaying the use of an antibiotic when the child is not terribly ill or the prescribing physician feels it is reasonable to adopt this approach. For infants younger than six months, or for those who appear sicker, antibiotics might be used without waiting.
It is important to remember that antibiotics aren't useful in treating viral infections.
They're not required for colds, flu, chest cold in otherwise healthy children and adults, sore throats (with the exception of those caused by strep bacteria), many cases of bronchitis in otherwise healthy adults and children, and many ear infections.
If your doctor does not feel an antibiotic is required, do not demand it -- it will not help treat the infection or make you feel better faster. If you are given an antibiotic, remember to take all the doses. Don't save any for "the next time" and never take anyone else's prescription antibiotics.
Have a conversation with your physician about what signs to look out for that might indicate an infection is getting worse and might need a medication to bring it under control.
For example, with a chest infection that causes wheezing, an inhaler might be used. You should also be given clear information about when reassessment is required.
Together, by using medication in an appropriate fashion, we will all benefit as a community and decrease antibiotic resistance.
</td></tr><tr><td valign="top">More on this in Health & Fitness
Comment