Don't Get Antibiotic Happy
Millions of children who see a doctor for a sore throat each year get prescriptions for antibiotics. But new research finds that in many cases it may not be the appropriate treatment.
Many parents who have a sick child complaining of a sore throat want a quick fix and wrongly think that antibiotics are the answer, demanding or pressuring their child's doctor into prescribing.
In fact, The Saturday Early Show's Dr. Mallika Marshall says a new study in the Journal of the American Medical Association found that doctors are still over-prescribing antibiotics to children complaining of sore throat.
The problem is the vast majority of sore throats are caused by viruses like those that cause the common cold and the flu, not strep throat.
According to the study, it's estimated that there are more than 7 million visits to the doctor for children with sore throat. Only about 15 percent to 36 percent of these cases are actually due to strep throat, which is a bacterial infection. The rest are mostly due to viral infections. Yet Harvard Researchers found that doctors actually prescribed antibiotics during 53 percent of these visits, much more often than was necessary.
It's virtually impossible to tell from simply examining the child to know if a child needs antibiotics or simply has a cold. Marshall notes the worst looking throats and tonsils can be caused by a viral infection. The only way to really know is to do a throat culture.
There are rapid strep cultures that can tell you in a matter of minutes, but these aren't always the most accurate. And then there's the throat culture than can take a couple of days to get the results. The Centers for Disease Control and the American Academy of Pediatrics both recommend that doctors perform a throat culture before prescribing antibiotics, but in the study about half of the doctors failed to do so. Also, in many cases, the antibiotics they prescribed were not generally recommended for treating strep throat.
The dangers of prescribing antibiotics unnecessarily to children are several:
Antibiotics can cause side effects, some more of a nuisance than anything else such as stomach upset or yeast infections
They can also cause serious allergic reactions in some people.
The unnecessary use of antibiotics can cause bacteria to become resistant to those drugs over time, leading to a breed of germs that become increasingly difficult to treat.
Doctors are slowly getting this message, but a lot of parents aren't. And they need to understand that the best thing for their child is to take antibiotics only if really necessary. Wait for the test results before insisting on a prescription.
For many conditions, there are both viral and bacterial causes such as pneumonia, bronchitis, ear infections, and sinus infections. And it can sometimes be hard to tell them apart.
To some extent treatment is based on the doctor's judgment alone. But in the case of a sore throat there is a reliable test that can distinguish between strep throat and a viral infection, so it can certainly cut down on the use of unnecessary antibiotics.
Parents, therefore, should ask the pediatrician whether antibiotics were really necessary or whether their child is likely to get better on his or her own.