Did you know that antibiotics are the most common cause of adverse drug reactions in children?
As much as 30% of all antibiotics prescribed in outpatient settings are unnecessary. Most of this inappropriate use is for respiratory infections such as sinus infections, ear infections, pneumonia, the common cold, asthma, respiratory allergies. And over one hundred thousand emergency room visits per year are due to antibiotic adverse reactions. Typical reactions can range from allergic drug rash, diarrhea, vomiting to anaphylactic shock, bone marrow suppression, renal failure, even death. Severe diarrhea secondary to C.dificile can lead to dehydration and sometimes fatality. Studies have shown that only half of patients with respiratory infections or urinary infections are receiving the recommended first-line drug treatments.
What about antibiotic resistance?
While adverse reactions to medications are individual and short term problems, antibiotic resistance is a community and global long term issue. The incidence of superbugs resistant to conventional antibiotics is rising. Factors contributing to resistance are use of antibiotics when it is unnecessary, prescription of antibiotics that are not first line therapy, and inappropriate dosage or duration of medications.
What can you as a patient do to help?
Let your doctor know that you are comfortable with “watchful waiting" and prefer not be treated with antibiotics unless it is absolutely necessary. Some Pediatricians may overprescribe because of pressure from anxious parents who are worried that if their child does not improve quickly they may miss work, school or a planned birthday party or vacation. Parents not uncommonly tell their pediatricians that their doctors have put adult family members on antibiotics for a respiratory infection and request antibiotics for their child. In reality, a viral respiratory infection or an environmental respiratory allergy will not improve with antibiotics.
Take your child to a doctor who has their records and knows their history. The after hour clinic, the minute clinic, the emergency room doctor will be more likely to overprescribe antibiotics because of lack of access to your child's medical records and lack of opportunity to follow up your child’s symptoms, increasing their liability. An emergency room physician or an after hour clinic provider is also more likely to prescribe a broad spectrum antibiotic or a “z-pack” rather than a first line therapy for the same reasons.
Please refrain from treating yourself from your child with a “left-over” or half-used bottle of antibiotics that you found in your medicine cabinet without consulting with your physician.
When you come home without antibiotics after an office visit with a doctor that you trust please do not think that you have wasted your valuable time or copay. You may have been to a physician who really cares about you, your child and your community. Please help raise awareness for antimicrobial stewardship.
Dr.Thuy Pham is an associate at Pediatric Specialists Medical Group and a Board Certified Pediatrician.