Antibiotics : Friend Or Foe?

Your doctor must examine your child properly, do all the possible checks for associated symptoms, and get a full understanding of their health before making a diagnosis and prescribing antibiotics. Professor Harry Seftel sheds light on what parents should know about antibiotics.

Used properly, antibiotics are an important ally to the human body, as they’ve revolutionized the treatment and cure of many infectious diseases. On the downside, they’ve also become a bit of a curse – perhaps, because they were so successful in the first place, that they went from being used rationally to irrationally, and with serious consequences.

Antibiotics: Friend Or Foe?

‘Germ aren’t just devils, but devilishly clever!’ says Professor Seftel as he explains how many of these microbial agents have become resistant to antibiotics as a result of being prescribed excessively. ‘It’s a major problem in public sector healthcare and probably an even bigger one in the private sector.’

Virus vs bacterial inflection

In winter, viruses are the major cause of inflection and are responsible for most of the common respiratory tract (throat, nose and airway) infections. While antibiotics only work to treat bacterial infections, doctors often (incorrectly) prescribe antibiotics for viral infections, telling their parents they can’t be 100 percent sure it’s only a viral infection, so, ‘to be safe’ they prescribe an antibiotic.

Virus vs bacterial inflection

‘It’s often difficult to work out whether an infection is viral or bacterial,’ says Seftel. However, often doctors don’t take the trouble to examine their patient carefully enough for associated symptoms to get to the bottom of the problem.

‘In South Africa we tend to think of the doctor as all powerful,’ he adds, ‘Whereas in the US, people challenge doctors more.’ This is an unfortunate scenario as the over-prescription of antibiotics creates an environment for the development of resistant germs. So, if your doctor wrongly prescribed antibiotics for your little one when they in fact had a viral infection and not a bacterial infection, they could be resistant to antibiotic treatment in the future if they get a bacterial infection. According to Seftel, Streptococcus (responsible for throat infections) doesn’t become resistant, but Pneumococcus (airway, lung, sinus, middle ear, bronchial infections and pneumonia) does.

Unfortunately, the price we pay for this is that cheaper, penicillin-based antibiotics are no longer always effective. So stronger and more costly, broad-spectrum antibiotics are prescribed. Theses ‘modern’ antibiotics are also responsible for a number of unpleasant, harmful and sometimes even life-threatening side effects.

Be rational and thorough … and get the doc to be, too!

It’s vital to understand a few simple things about the nature of viral versus bacterial infections, so you can ensure your doctor is being thorough enough in his examination and accurate in his diagnosis. Remember, your doctor isn’t always right, and there are those who’ll take short cuts.

you can ensure your doctor is being thorough enough in his examination and accurate in his diagnosis.

Your doctor must examine your child properly, do all the possible checks for associated symptoms, and get a full understanding of their health before making a diagnosis and prescribing antibiotics. If you’re not asked for this, be proactive and insist on telling your doctor about your child’s medical history.

Common side effects

Take a broad-spectrum antibiotic and you could experience diarrhea or allergies as side effects. Allergies can range from rashes to potentially fatal reactions, such as anaphylactic shock (this is rare). Initially, penicillin didn’t cause allergies, but due to overuse we now have to use more expensive varieties and suffer the incumbent side effects including fungal infections, such as thrush (Candida) and other, so-called ‘super infections’ that are more difficult to treat, requiring an altogether different set of antibiotics.

So where does this leave you, the concerned parent who wants to do the best for your children? Here’s what Professor Seftel suggests you do:

1. Scenario 1

Your child has a runny nose, sore throat and red eyes, with no other symptoms.

Runny nose

·         Likely To Be

A viral infection, antibiotics aren’t needed.

2. Scenario 2

In addition to the above, she looks sick, has a sore throat and a fever. The glands in her neck feel swollen to you.

·         Likely To Be

A bacterial infection or both viral and bacterial.

·         What To Do

Insist the doctor checks for swollen glands and takes a throat swab. Ask him whether there are pus-filled yellow points (purulent material) coming out of the tonsils when he examines them, or if they’re just red and enlarged. Purulent material combined with redness and swelling is likely to indicate a bacterial infection, whereas redness and inflammation alone tend to be viral.

3. Scenario 3

Your child has a range of symptoms, including a ‘phlegm’ cough.

A ‘phlegm’ cough

·         Could Be

a combined viral and bacterial infection.

·         What To Do

Get them to cough up some phlegm and examine it. If it’s green or yellow, take them to the doctor and get the same check done there. In general, yellow or green phlegm could need antibiotics.

4. Scenario 4

Your child has diarrhea.

Your child has diarrhea

·         What To Do

Get your doctor to examine the stool and do a rectal examination.

·         Likely To Be

If the stool’s watery, and there’s no blood in it, it’s likely to be viral. The last thing you need here is antibiotics, which could worsen the diarrhea, as it’s a common side effect. If there’s blood in the stool, it’s probably a bacterial infection. Even when this is the case, antibiotic treatment may not be necessary.

You can help treat the diarrhea by ensuring your child is adequately hydrated. They need to drink small amounts (a quarter cup of liquid) frequently, suggests Professor Seftel.

A combination of water, sugar and mineral salts, as found in electrolyte solutions from the pharmacy, are excellent.

5. Scenario 5

You have a particularly vulnerable child who suffers from asthma, bronchial infections or HIV/Aids.

Child who suffers from asthma, bronchial infections or HIV/Aids.

·         What To Do

Don’t take any chances when they get sick, as they may indeed need antibiotics to ensure they don’t end up in hospital.

Tip

Plain, full-fat yoghurt is an excellent probiotic to give your child to help prevent antibiotic side effects such as thrush and diarrhea.

Professor Harry Seftel is well known for co-hosting A Word on Medical Matter with Leigh Bennie on Talk Radio 702. He spent more than 50 years as a student clinician, teacher, researcher and administrator in the Department of Medicine at Wits University. His many awards and distinctions include three professorships (medicine, African diseases and clinical research), authorship of over 200 publications in a variety of medical areas and an honorary LLD (Doctor of Laws.)