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Antibiotic stewardship – how parents can help

Your child has a fever, runny nose and glassy eyes. You rush her to the pediatrician, eager for the magic antibiotic that will wipe out the bad bugs and return her to her happy, healthy, self – but (plot twist) your doctor doesn’t prescribe an antibiotic, and you’re sent home empty-handed (gasp)! As hard a pill as this lack of medication may be to swallow, just know that your doctor has very likely done your child a favor.

While antibiotics are essential, if you’re dealing with a bacterial infection, the reality is many childhood illnesses are caused by viruses against which antibiotics are completely useless. What’s more, overusing antibiotics when they’re not required is a problem because it wipes out healthy bacteria that account for roughly half the cells in our bodies. All of this means it’s important to use antibiotics sparingly, and only when they’re necessary.

Keep reading to learn more about some common childhood symptoms/conditions that don’t necessarily require antibiotics…


Up to 90 percent of all fevers in young kids are triggered by viral infections (like the flu or cold) — in which case it does not require antibiotics. However, a fever that’s triggered by bacteria (like strep throat or a urinary tract infection) will usually — though not always — require antibiotics. Fevers are part of the body’s natural defense against infection, and your doctor can help determine whether the infection causing the fever needs further treatment or will get better with rest and lots of love from you.

Since some fevers can be serious, it’s essential to:

• Seek medical care immediately if your baby is under three months and has a fever over 100.4 degrees Fahrenheit; or if a child of any age has trouble breathing, or is not drinking or peeing; is lethargic, looks very sick, and/or has not received all recommended vaccines.

• Call your pediatrician if your baby over three months has a fever, or if your toddler or older child has a fever that’s not getting better after two to three days.

If you have any questions or need reassurance, call your pediatrician.

Ear infection

There are two types of common ear infections – otitis media with effusion, when the middle ear becomes clogged with fluid due to allergies or irritants (like cigarette smoke), and acute otitis media, when infection is caused by a bacteria or virus. With any ear infection, a baby will usually pull at the infected ear; other symptoms include difficulty sleeping (pain often becomes worse at night), fever, fatigue and crankiness.

If you think your child has an ear infection (and especially if she has a fever), see your pediatrician. He or she will often prescribe antibiotics to treat it, but may take a wait-and-see approach depending on whether both ears are infected, how severe it looks, how old your child is, how high the fever is and how long your child has been sick.

Sore throat

A sore throat is often the first sign of a cold virus infection, which does not require antibiotics. But about one in four sore throats in kids is caused by strep throat, according to the United States Centers for Disease Control (CDC) — a bacterial infection that does require antibiotics. So, how can you tell the difference? If your child has strep throat, that sore throat will usually be accompanied by fever, swollen tonsils, tiny red spots on the roof of the mouth, and swollen lymph nodes in the neck.

Simply having the above symptoms, however, is not enough to make a strep diagnosis (swollen tonsils, for example, often accompany a cold virus or allergies). A simple test at the doctor’s office can diagnose strep throat, so be sure to see your doctor to get a proper diagnosis and treatment.

Pink eye

Pink eye (aka conjunctivitis) can be caused by bacteria, viruses, allergens (like pollen) or other irritants (like swimming pool chlorine). It can be difficult to nail down the exact cause of pink eye, even for doctors — so, if the white of your child’s eye turns red and looks swollen, see your child’s doctor for treatment.

Green mucus

When mucus turns yellow or green, it’s known as sinusitis, an inflammation of the nasal cavity. Bacteria aren’t always the cause of this inflammation — it can be triggered by allergies or a viral infection like a cold. In fact, bacterial sinusitis is actually relatively uncommon. So, unless a child has an accompanying fever, and/or other symptoms (like cough) worsen, doctors now take a wait-and-see approach for 13 days before prescribing antibiotics.

When your child is sick, it’s natural to want a magic pill that will make all their symptoms go away. Most times, antibiotics are not it. Time and patience are often the best medicine. Remember, your pediatrician is a valuable resource for helping you raise happy, healthy kids. Ask for the best ways to manage your child’s symptoms and resist the urge to request antibiotics if your doctor didn’t recommend them. You’ll be doing your part to avoid antibiotic resistance in your child and community.

• Dr. Tamarra Moss is a pediatrician committed to helping you raise happy and healthy kids. You can find her at Dr. Carlos Thomas & Pediatric Associates in New Providence, Lucayan Medical Center in Grand Bahama, or on Instagram 

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