Antibiotic Overuse

Recently there has been an outrage against the inappropriate use of opiates in the adult population. This has risen to the forefront due to the recent deaths of a number of well known celebrities. While tuning in to the new documentaries and television shows being made about prescription drug addiction, I noticed comments referring to medical clinics as “shopping centers” and similarly physicians being referred to as “pill pushers”. This all made me think of a similar phenomenon in pediatrics where parents tend to “shop” for antibiotics for their children. This practice can be both unnecessary and potentially harmful in the long run.

There is a common misconception that a fever in a child is a bad thing. Somehow over the past few years, fever and self limiting illnesses such as stomach viruses and viral upper respiratory tract infections have become scary and un-natural to parents. I believe that in this new era of medicine becoming more of a business; controlled by seeing as many patients as possible in the shortest amount of time, parent education has resultantly become lacking.

Fever is in fact one of the body’s natural ways to fight an infection. The vast majorities of infections in a child are viral in nature and are self limiting; i.e. they should be treated symptomatically until the virus clears the human body. These viral infections are the very things that result in strengthening of the immune system of such a child.

The overuse of antibiotics has led to rampant development of antibiotic resistance in bacteria. This leads to a much more difficult treatment process in a child who is in fact suffering from a bacterial infection which requires antibiotic treatment. It is not only the child who may have had unnecessary antibiotic treatment earlier in life who is affected, but actually the entire community. Sounds a bit confusing? Let me clarify. In a community where there is repeated overuse of antibiotics or inappropriate usage, (shorter duration than recommended for particular infection type or incorrect antibiotic for a specific type of infection) there will be a development of drug resistant bacteria. These antibiotics will therefore have a lower level of efficacy in all individuals in that community. Given that this phenomenon of antibiotic overuse is occurring throughout the US, and throughout most parts of the world, antibiotic resistance is being seen more and more, resulting in the need to re-treat infections with a second and sometimes third course of antibiotics. This in turn increases the incidence of known side effects of some commonly used antibiotics in the pediatric population. One of these side effects is a type of intestinal infection called C. Diff colitis, an infection which can become quite severe and can potentially be fatal. The overuse also results in a continuous necessity to manufacture newer antibiotics. This potentially results in a higher cost to the customer, as well as less knowledge of potential short or long term side effects.

Make no mistake antibiotics are necessary in some instances, but we should be wary as parents and caregivers, of physicians who are very quick to write prescriptions for a course of amoxicillin or any other antibiotic. Drugs are often not the answer, specifically in pediatrics. Sometimes all that is needed is some tender loving care. Question your child’s physician about your child’s illness. What is the diagnosis? What is the recommended treatment plan for such an infection? What symptoms should I become concerned about? Is there anything I can do to prevent this from happening again? As a pediatrician, these are questions I love to be asked during office visits. Do not demand medications that may actually cause harm to your child. Have meaningful discussions with your health provider about your child’s well being.