If I had a dirham for every time I’d been asked why antibiotics are not needed for a child who has a sore throat, runny nose and cough, I would be a rich man.
The simple answer is that 95% of the kids I see with the above symptoms have nothing more than a common cold.
That’s not to say they’re not unwell and feeling lousy. As a father of two small children myself I would never underestimate how difficult it is to see your child under the weather, but the simple fact is that antibiotics do not treat a common cold, or the flu, because they are viral infections.
Antibiotics only work against bacterial infections.
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What is the problem with using antibiotics for a viral infection?
Since antibiotics were discovered in the 1940s they have saved millions of lives. Illnesses that were once considered life-threatening – pneumonia, strep throat and scarlet fever – are now entirely manageable thanks to antibiotics.
But there has been a lot of publicity in recent years about the global problem of antimicrobial resistance (AMR).
Put simply AMR means that many of those life-saving antibiotics are now becoming ineffective because we have developed resistance to them.
This has been caused by many years of over-prescribing by doctors, often when the antibiotic wasn’t necessary in the first place, and a failure by many patients to complete prescribed courses of the medicine when they were required.
As a result, the world is fast running out of antibiotics that work and, in a nutshell, AMR has become one of the biggest threats to global health.
"AMR has become one of the biggest threats to global health. Every single one of us has a duty to use antibiotics responsibly"
If it continues we will soon be in a position where we won’t be able to treat many of the most common bacterial infections with antibiotics and medical procedures such as organ transplants, cancer chemotherapy, diabetes management and major surgery will become very dangerous due to the high risk of infection.
These are problems that will affect us all so each and every one of us has a duty to use antibiotics responsibly.
What are the symptoms of a viral infection?
The typical symptoms of a viral infection include:
• Blocked or runny nose
• Sore throat
• Muscle aches
• High temperature
• Pressure / pain in the ears and face (young kids often tug their ears)
• Loss of taste and smell
When our children get ill our parental instinct kick in and we would do anything to make them feel better, including begging our GP to give them antibiotics.
But, as we now know that in most cases, this is futile.
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There are, however some exceptions.
For children under the age of two with an ear infection (that may or may not be viral) we would probably err on the side of caution and prescribe antibiotics. This is because a child of that age is not able to tell us where the pain in located, and due to the small size of their ear canals it is often difficult to conduct a thorough examination. Children under two also get sicker more quickly so we want to avoid complications such as mastoiditis – when an ear infection spreads to the skull.
However, in the vast majority of cases, the best advice I can give, if your child has any of the above symptoms, is to stay home and do the following:
• Ensure they get plenty of rest and sleep
• Keep them warm
• Give them plenty of water to drink to avoid dehydration
• Use paracetamol or ibuprofen (not given together) to lower temperature (normal is 36.5°C) and ease aches and pains. If your child is not grizzly, lethargic and/or not drinking we often advise not to treat temperature below 39.0 as this is the body’s natural way to fight infection.
Remember the symptoms can come on slowly and your child might feel terrible, but after a few days they should start to feel better.
Read more: 'What to do when your baby or child has a fever'
When should I see a doctor?
It is however important to see a GP if:
• Symptoms don’t improve after 3-5 days
• Symptoms suddenly get worse
• The child’s temperature goes over 39°C or they feel hot and shivery
• You are concerned about any of your child’s symptoms
• Your child is finding it hard to breathe, breathing quickly or they develop pains/discomfort in their chest
• They have a long-term medical condition – for example, diabetes or a heart, lung, kidney or neurological disease
• They have a weakened immune system – for example they have recently received chemotherapy or radiotherapy)
Dr Richard Jones is a British family medicine doctor (GP) treating both children and adults. He also specialises in sport and exercise medicine.
Contact him ay Keithnicholl.com / 04 394 1000