Doctors tell you everything you ever wanted to know about these wonder drugs.
Your little one has high fever? and a sore throat and you ?can’t resist reaching for that? magic medicine that will relieve her of her misery (and you of yours). An antibiotic seems like a good option. Well, it just might be a good idea to desist.
1. Antibiotics do not treat viral infections.
“Almost 90 per cent of all childhood infections (coughs, colds, bronchitis, stomach upsets and fevers) are viral in nature and antibiotics need not be prescribed,” says Dr. Sandeep Jathanna, Paediatrician. Most of these illnesses run their four – to seven – day course. “If the fever continues to spike after five days, it could be a secondary infection caused by bacteria,” says Dr. Jathanna. In this case, your doctor may prescribe a course of antibiotics.
2. They treat bacterial infections only.
For bacterial infections like strep throat, middle-ear infections, urinary-tract infections, typhoid, bacterial pneumonia or meningitis, an antibiotic may be needed,” says Dr. S. M. Vaidya, Senior Consultant Paediatrician, Chiranjeev Clinic, Mumbai.
3. Resist the temptation to self-medicate.
Only your paediatrician can take an informed decision, as it is not just about the right drug, but also about the dosage.
4. Specific antibiotics are given for specific illnesses.
“If an antibiotic worked once, it does not mean it will work again, or that it will work on your neighbor’s kid,” says Dr. Mathai, Paediatrician.
5. Avoid sharing.
“Never share eye or nasal medication, even if two children have the same infection” says Dr. Vaidya. The applicators usually touch the eye or nose and a child with a milder infection could develop a more serious condition. Though syrups and suspensions can be shared, use separate spoons or cup measures.
6. Complete the course.
Don’t stop the medicine just because your kid is looking or feeling better. ‘Sometimes the treatment for serious illnesses like meningitis or middle-ear infections can take up to two weeks,” says Dr. Vaidya. Stopping medication before your kid completes the course can prove harmful. “The germs may develop resistance to the drug, requiring a much stronger antibiotic the next time your kid is ill,”.
7. Throw out half-used meds.
Never save antibiotic syrups and suspensions in the hope of using them in a recurring episode as the medicines deteriorate over time.
8. Follow dosage instructions carefully.
For premixed suspensions, use the measuring cup provided, as doses are measured in millilitres (ml). Teaspoon sizes can vary rendering them inaccurate. “It Is important that all dry powder suspensions are mixed with the right amount of water, or your child will not get the correct dosage,” says Dr. Sisir Paul, Child Advisor. Shake all suspensions before dispensing so the contents are well mixed. “Dispersible tablets are a good idea, as they give a more accurate dosage,” he says.
9. Do not break, crush or alter a pill.
If your child is unable to swallow pills, check with the doctor before breaking or crushing them. “If the tablet is labelled sustained release’, it cannot be broken or crushed,” says Dr. Paul.
10. Timing is important.
The effectiveness of the meds is reduced if the time gap between doses is more than prescribed. “Three times a day means every eight hours,” says Dr. Mathai. “After that time, the level of antibiotic in the body begins to fall and the bacteria can rejuvenate.” Do not repeat the doses more frequently than prescribed. “As doses for children are prescribed according to the their weight, giving them more than required could lead to side effects like diarrhoea,” says Dr. Vaidya.
11. Pay attention to storage.
Antibiotics can be stored at room temperature. “However, drugs like amoxycillin and Augmentin may require refrigeration in the summer months,” says Dr. Vaidya. In India, when room temperatures could touch 40°C in the warm weather, you may need to refrigerate syrups and suspensions. Read instructions on the bottle and ask your doctor for advice.
12. Avoid antibiotics just after a meal or a drink of milk.
Antibiotics can be given on an empty stomach or between meals. “Generally, we advise that the medicine be given an hour before food,” says Dr. Vaidya. The presence of food in your child’s stomach can interfere with the proper absorption of the antibiotic thus reducing the effect of the medicine on your child’s body. “Some antibiotics like rifampicin or oral penicillin have to be given half an hour before food,” says Dr. Mathai. Ask your paediatrician for specific instructions so that your child gets maximum benefit from the prescribed medicine.
13. Skip antacids.
The proper absorption of the antibiotic from the stomach is adversely affected by the presence of antacids in your child s stomach.
14. Always buy the specific drug prescribed.
Some drugs are fake and manufactured by local companies. For example, instead of Septran, pharmacists sell Septrin, which is fake” Dr. Mathai explains. Check with your doctor if the drug prescribed is unavailable in the market.
15. Make sure your child gets adequate rest and fluids.
This does not mean your child has to be confined to bed. “Don’t send your child to school if he looks better after a couple of days. In school he will have to sit all day, play outside and won’t be able to sleep if he’s sleepy” says Dr. Paul. Let him stay home till the doctor advises otherwise. Try to keep your child as hydrated and fed as usual If your child is not eating properly, it is a good idea to give him nutrient-rich liquids like lime juice, coconut water or soup.
16. Inform the doc of other medication.
Drug-drug interactions can sometimes prove harmful. “For example, if a child is being treated for infection of the liver, the erythromycin group of drugs cannot be prescribed,” explains Dr. Vaidya.
17. Tell the doc about drug allergies.
You must also inform her of any family history of drug allergies. If there is a family history of allergy to sulfa drugs, your child could have it too. If this is the case, drugs like tetracycline and penicillin cannot be prescribed. “Usually allergies appear in the form of a rash and a very severe reaction is unlikely,” says Dr. Paul. If your child experiences great discomfort, your doc may prescribe an anti-allergic, or change the medicine.
18. Antibiotics may have side effects.
Some antibiotics can have side effects like loose motions and vomiting. “Antibiotics kill friendly bacteria in your child’s intestines,” explains Dr. Jathanna, This could cause diarrhoea. Vomiting could be caused by an aversion to the taste or acidity caused by the medicines. These symptoms are usually mild and easily controlled. “Properly administered, the benefits of antibiotics far outweigh the discomfort of side effects” says Dr. Vaidya. Inform your doctor about any discomfort your child is experiencing and he will give you something to lessen it If your child is passing dark urine, has developed swelling of the body or severe itching, consult your doctor immediately. “Severe reactions are unlikely, unless the child is suffering from rare G6PD deficiency,* says Dr. Paul.
19. Supplements are usually not needed.
“If your kid is on broad-spectrum antibiotics or needs to take antibiotics over a long period, we prescribe B complex or lactobacilli and probiotic supplements,” says Dr. Paul. These help to replace the friendly bacteria in your kid s intestines, which are destroyed by antibiotics.
20. Don’t force your doc’s hand.
“Quite often antibiotics are prescribed on ‘request’ from an anxious parent,” says Dr. Mathai. The unnecessary use of antibiotics has made several strains of bacteria resistant to them. For example, several types of bacteria causing middle-ear infections have become resistant to amoxycillin, the most frequently prescribed antibiotic for ear infections. This means much stronger antibiotics have to be used to fight even simple infections in children.