15 June 2007

Antibiotics in Children

I have met parents whose knee-jerk reaction (read: without consulting doctors) is to give their sick children antibiotics whenever they are sick. No matter if it is a mere symptom of the common cold --- which we all know will resolve on its own given proper care and bed rest.

I also know of some mediocre GPs (general practitioners) who are easily "pressured" by mothers of these sick kids into prescribing antibiotics to treat what is well-known to be self-limiting respiratory viral infections. Why? Don't ask me why. It's a combination of attitude and culture, I guess. Some parents think all illnesses need prescriptions, and doctors are supposed to give them on request. How foolish, you say? You can read more of these amusing incidents in my post here.

Here comes news that early antibiotic use is linked with childhood asthma. The abstract of the study is here.

The culprit is not just simple antibiotics like amoxicillin, but broad-spectrum cephalosporins.

It might seem like an overkill response but yes, I've witnessed "pressured GPs" here prescribe strong cephalosporins to kids with runny nose and cough. What's the problem with that?

The study author had this to say:
"Antibiotics are prescribed mostly for respiratory tract infections, yet respiratory symptoms can be a sign of future asthma. This may make it difficult to attribute antibiotic use to asthma development."

The study showed that antibiotic use during infancy is a risk factor for the development of childhood asthma, and with 4 or more antibiotic courses, the risk of asthma can increase to 46 percent.

4 reactions:

bayi said...

Parents sometimes think they know better than doctors. It's exasperating but true. Tragically, they try to perduade some GPs to prescribe antibiotics and they think they do it out of love for their children.

I have even seen ignorant parents who are convinced that certain medicines are so effective that they insist on these for their children's conditions. Of course, these medicines are efficient (not necessarily eccective in the long run) because they contain steroids. And if doctors give in without issuing a strong warning, they are also wrong.

Char said...

Hi Doc Emer! Yep, even we dentists encounter patients /parents like these. A lot of the patients even think that the antibiotics are the sole thing that takes the pain away. A lot of them do ask for antibiotics, but when I tell them that they need to take, like for example, 21 capsules, they balk,,,"GANON KA DAMI???"

jim said...

The attitude of patients going to a physician is like our own when we go and see a movie.It better be worth the time and money we spend on watching it.Patient specially the less educated one don't want to go home with just a simple prescription for an analgesic and a decongestant medicine.They are expecting that they be given an antibiotic prescription. Even though the common colds will go away the same time with or without antibiotics , the act of giving antibiotics to their child is comforting to them.

nikki said...

This is a problem I frequently encounter. Parents get so disappointed when they visit you and you just prescribe lots of fluids & a cough syrup. I always explain to them that there is no indication for antibiotics for a simple bout of cough. Perhaps this study will finally convince those parents to be happy with what I prescribed.