Antibiotics and the common cold.
Upper respiratory infections (also known as the common cold) are extremely common in children. Worldwide, children under 5 years old average 8 colds a year. Symptoms include runny nose, cough, fever, fatigue, irritability, and decreased appetite. Viruses cause over 90% of upper respiratory infections.
The cold itself doesn't cause as much concern as the possibility that the cold will evolvle into a lower respiratory infection such as bronchitis, serious respiratory illnesses.
The natural course of some viruses is to begin as an upper respiratory infection, and then evolve into a lower respiratory infelction. If the child is infected with certain strains of respiratory syncytial virus, influenza virus or parainfluenza virus, then it is very common for a lower respiratory infection to occur. Treatment with antibiotics does nothing to prevent this progression.
Sometimes a viral upper respiratory infection can cause a separate bacterial infection such as otitis media, sinusitis, pneumonia, tonsillar disease, mastoiditis, and even meningitis. Would antibiotic treatment of the viral infection prevent the subsequent bacteria infection?
The answer seems to be "No." Giving a child with a viral infection an antibiotic doesn't alter the odds of getting a subsequent bacterial infection. And antibiotics do nothing to shorten the course of the upper respiratory infection.
Not only does antibiotic treatment not help, but it may be harmful. There's always the risk of side effects from the antibiotic, even if the child has taken the drug many times before with no problems. Inappropriate. antibiotic use may lead to what's called a "superinfection." This type of infection is caused by bacteria which are resistant to many antibiotics and are frequently very difficult to treat.
So if antibiotics don't help, why do so many doctors prescribe them for upper respiratory infections? Sometimes parents expect "something" to be done, and what they expect is often antibiotics. Doctors may worry about missing a more serious underlying disease, underestimating the severity of the disease, or fear the results of an undiagnosed streptococcal infection. Some doctors use the writing of a prescription as a way to end a visit, and find it easier to follow this pattern. Lastly, the doctor may worry that if complications occur the patient will not return to the office.
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|Publication:||Pediatrics for Parents|
|Date:||Sep 1, 1993|
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