Antibiotics: When Do They Help  
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Definition: Antibiotics are strong medicines that can kill bacteria. Antibiotics have saved many lives and prevented bacterial complications. However, antibiotics do not kill viruses. One of the decisions healthcare providers make every day is whether a child's infection is viral or bacterial. Consider their perspective.

Bacterial Infections: Antibiotics can help and will be prescribed

Bacterial infections are much less common than viral infections. Bacteria cause:

  • Most ear infections (but they only happen to 5% of children with a cold)
  • Most sinus infections (but they only happen to 5% of children with a cold)
  • 20% of sore throats (Strep throat infections)
  • 10% of pneumonia (bacterial lung infection)

Viral Infections: Antibiotics do NOT help

Viruses cause most infections in children including:

  • Colds present for less than 2 weeks, unless they turn into an ear or sinus infection
  • Coughs present for less than 3 weeks, unless they develop a bacterial pneumonia
  •  95% of fevers
  •  80% of sore throats
  •  90% of pneumonia (most pneumonia in children is viral)
  •  99% of diarrhea and vomiting

Cold Symptoms that are Confusing but Normal

These symptoms are sometimes mistaken as signs of bacterial infections and a reason for starting antibiotics:

  • Green or yellow nasal discharge. This is usually a normal part of recovery from a cold, rather than a clue to a sinus infection.
  • Green or yellow phlegm (sputum). This is a normal part of viral bronchitis, not a sign of pneumonia.
  • High fevers. A high fever (over 104 F or 40 C) can be caused by a virus or a bacteria.

Side Effects of Antibiotics

All antibiotics have side effects. Unless your child really needs an antibiotic, there is no reason to risk the side effects of the medicine. Some children taking antibiotics develop diarrhea, nausea, vomiting, or a rash. The diarrhea usually occurs because the antibiotic has killed off the healthy intestinal bacteria. And if your child gets a rash, your doctor must decide if the rash is an allergic reaction to the drug or not. The biggest side effect of overuse is increasing resistance to the antibiotics.

Giving Antibiotics for Viral Infections: What Happens?

If your child has a viral illness, an antibiotic will not shorten the course of the fever or help the other symptoms. Antibiotics will not get your child back to school or you back to work sooner. If your child develops side effects from the antibiotic, he will feel worse instead of better.

What You Can Do

  • Save antibiotics for diagnosed bacterial infections when your child really needs them
  • Don’t pressure your child’s doctor for a prescription for an antibiotic
  • Treat your child’s cold and cough symptoms with home remedies that work
  • Remember that fever is fighting the infection and producing antibodies to prevent future viral infections.

Author and Senior Reviewer: Barton D. Schmitt

Content Set: Pediatric HouseCalls Symptom Checker

Pediatric HouseCalls Symptom Checker