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Most Childhood Infections DON’T Need Antibiotics Your child has a runny nose, cough, sore throat and fever, so you go to the pediatrician. The doctor knows a virus caused this infection, which will run its course. You're worried, so you push the doctor to prescribe antibiotics. The doctor gives in. Who's wrong? Both you and the doctor, experts say. Most childhood fevers are caused by viruses, are not serious and will pass by naturally without causing severe harm. Antibiotic treatment is not only expensive and unnecessary, it will actually harm your child, according to Kapi`olani's Pediatric Infectious Disease Team. Other national experts agree. According to Texas pediatrician Carol J. Baker, M.D., an infectious disease expert and spokeswoman for the American Academy of Pediatrics, “at least three-quarters of the infections most pediatricians see in an office are viral, with no complications. Viruses cause colds, for instance, and symptoms can last five to 10 days. Making sure the child is getting adequate fluids and [children’s acetaminophen] is all that's necessary.” Marian Melish, M.D., a member of Kapi`olani's Pediatric Infectious Disease Team, explains why antibiotic overuse is dangerous. “Giving an unneeded antibiotic will breed strains of bacteria that the drug won't kill. The next time the drug is used, it may be useless. In Hawaii, resistance to the most important antibiotics for common bacteria such as Staphylococcus and Pneumococcus has skyrocketed. If your child gets pneumonia or a skin infection with one of these germs, the illness will continue to progress if treated with the usual drugs. At best it will delay recovery until the right drug is found; at worst it could even cause death. “Already in 2004, a child in Hawaii died of a widespread infection that started as a small boil on the knee,” Dr. Melish explains. “The Staph germ responsible turned out to be resistant to the usual antibiotic, which the child had taken before. Before drug resistance was recognized and a new type of antibiotic could be given, the infection had spread to the lungs, bones and muscles, causing shock and death. “Another reason for giving antibiotics only when absolutely needed is that they also cause various side effects, such as stomach upset, abdominal cramps, diarrhea and yeast infections. “It is not only the child, but the whole community that suffers,” warns Dr. Melish. “Resistant bacteria bred in your child's body during antibiotic treatment can pass to other family members and friends, spreading the problem.” Marian Melish, M.D. Ask questions! So how do you know when your child needs an antibiotic? Leave that to the doctor. If an antibiotic is prescribed, always ask: What is the diagnosis? Is the antibiotic really needed? Would it be a good idea to wait or test before treatment? When antibiotic treatment is required, it's important that your child take the medication exactly as prescribed. Don't miss doses and don't stop the medication early. Otherwise, the bacteria can adapt to the antibiotic and become completely resistant. Here are some common illnesses and guidelines as to which ones usually require antibiotics. Ear infections — Some need antibiotics, but many do not. Colds — Because colds are caused by viruses, antibiotics have no effect on them. It is normal for mucus to thicken and change color during the course of a cold. Sinus infections — Most children with thick or green mucus do not have a sinus infection. For long-lasting or severe cases, antibiotics may be needed. Cough or bronchitis — These problems rarely require antibiotics. Sore throat — Most are caused by viruses. Strep throat is the only infection that requires antibiotics, and must be diagnosed with a laboratory test. Pneumonia — Antibiotics may or may not be needed, depending on the underlying cause. It is diagnosed with a chest X-ray. Skin Infections — If caused by bacteria, antibiotics by mouth or by topical ointment may be needed.