Children's Hospital Colorado

Antibiotics: When Do They Help?

Barton D. Schmitt, M.D.

Antibiotics are strong medicines that can kill bacteria. They have saved many lives and prevented bad outcomes. These drugs do not kill viruses. They only work on bacteria. Every day, doctors must decide if a child's infection is viral or bacterial. Here's how they do it:

Bacterial Infections. Much less common than viral infections. Antibiotics can help. Bacteria cause:

  • Most ear infections
  • Most sinus infections (not sinus congestion)
  • 20% of sore throats which are Strep throats
  • 10% of pneumonia (a lung infection)

Viral Infections. Most infections in children are caused by a virus. Antibiotics do not help. Viruses cause:

  • 100% of colds. (Note: unless they turn into an ear or sinus infection. This happens with 5 to 10% of colds.)
  • 95% of new coughs. (Note: asthma can also start with a cough.)
  • 95% of fevers
  • 80% of sore throats
  • 90% of pneumonia. (Note: most cases in children are caused by a virus.)
  • 99% of diarrhea and vomiting
  • Note: There are a few anti-viral drugs that can treat viral infections. An example is Tamiflu used for severe influenza.

Cold Symptoms that are Normal

Parents sometimes are worried about common cold symptoms. The symptoms below are not signs of bacterial infections. Nor, are they a reason to start antibiotics.

  • Green or yellow nose discharge. This is a normal part of getting over a cold. It is not a clue to a sinus infection.
  • Green or yellow coughed up phlegm. This is a normal part of getting over viral bronchitis. It is not a sign of pneumonia.
  • High fevers. High fevers (more than 104° F or 40° C) can be caused by a virus or bacteria.

Side Effects of Antibiotics

All antibiotics have side effects. Some children taking these drugs can get side effects. Examples are diarrhea, nausea, vomiting, or a rash. Loose stools occur because the drug kills off the good bacteria in the gut. If your child gets a rash, it can be from the drug. Your doctor has to decide if the rash is an allergy or not. The biggest side effect of overuse is called antibiotic resistance. This is when the germs are no longer killed by the drug. That's why we only use antibiotics if your child really needs one.

Giving Antibiotics for Viral Infections: What Happens?

If your child has a virus, an antibiotic won't get rid of the fever. It will not help the other symptoms. The drug will not get your child back to school sooner. It will not get you back to work any faster. If your child has side effects from the drug, he will feel worse.

What You Can Do

  • Save antibiotics for bacterial infections when your child really needs them
  • Don't pressure your child's doctor for an antibiotic
  • Treat your child's cold and cough symptoms with home treatment that works
  • Keep in mind that fever is fighting the infection. It also boosts the immune system to prevent future infections.

Disclaimer

The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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