Prescription for trouble white too many antibiotics aren't good for kids
Every night for a week. I set my alarm clock for 2 a.m.
So I can wake my three-year-old daughter Devon for yet another dose of her icky medicine
I sit on her clamp her arms down pinch her nose shut and slowly squirt a teaspoon of thick
Greenish yellow liquid into her mouth. We repeat this wrestling match every six hours
I feel like the worst mommy in the world
Unfortunately, there's no better option Devon has a recurring urinary tract infection
UT caused by bacteria that are resistant to most antibiotics
It only responds to one oral drug that's approved for kids a liquid with a taste
Texture and odor that cherry flavoring can't disguise. I worry. What will happen if the bacteria
Eventually become resistant to that antibiotic too
Before Devon got sick. I knew that mus using antibiotics could lead to the evolution of so-called superbugs
But I didn't really think about those germs striking my family now. I know better
although we talked about
Antibiotic resistance as a public health issue it's an individual child who gets an infection says Arjun
Sreenivasan MD a medical epidemiologist at the Centers for Disease Control and Prevention
CDC a new drug problem in fact many everyday childhood illnesses are becoming increasingly
Hard to treat you've probably heard about em RSA
methicillin-resistant Staphylococcus aureus
Potentially deadly bacteria that don't respond to commonly used antibiotics
A new study analyzing data from more than 300 hospitals found that there's been an alarming increase in ear
Sinus and throat infections and children that were caused by air Maura say
However, the problem isn't limited to one super bug
two-year-old Sloane pothe of Charlotte, North Carolina
Needed surgery last year for a skin infection caused by another strain of drug-resistant bacteria on Monday it
Like diaper rash by Friday. She was in the hospital
She's fine now
But it was very scary says her father Michael
The surgeon said that he's now seeing two or three serious cases like hers every week
Although most antibiotic resistant infections aren't necessarily
life-threatening
Pediatricians who can't use their first choice antibiotic may have to prescribe a drug that's not approved for children
or simply isn't kid-friendly if
Medicine doesn't taste good children won't swallow it and then your only option is to give them a shot says me go higher amatsu
MD a
pediatrician in Castro Valley, California
For Mr. A say, however there are no outpatient shots that work
So a child who won't take oral antibiotics will need to be hospitalized for four antibiotics
It's a huge ordeal for the types of infections. That would have been very easy for us to cure 20 years ago says dr.
Hiram ETSU treating a resistant infection is also costly in terms of both time and money not to mention
anxiety and lost sleep
Karen by lazier Ian's sixteen month old son Carson
Suffered from a painful ear infection for nearly a month until his fourth antibiotic finally did the trick?
Every week we were going back to the doctor and the pharmacy says by lazier Ian who lives in Wrentham
Massachusetts
Carson had never needed antibiotics before so I was shocked when the first three didn't work
With the fourth one we saw a difference very quickly when it worked it worked the path of most resistance
Every child has colonies of helpful and harmful bacteria living in his body
Within those colonies a few individual strains of bacteria may have a natural ability to resist certain
antibiotics so whenever your child takes an
antibiotic the germs that are susceptible to that drug die leaving more room for the drug resistant microbes to
Reproduce and become dominant the same thing can happen when your child doesn't finish his whole course of
antibiotics either way the strong survive if your child develops a sizable population of resistant bacteria
After taking an antibiotic it doesn't necessarily mean she'll become ill
The new bugs may simply live in her body in which case she's said to be colonized or they may disappear over time
under the right circumstances
Though she could get sick with a tough to treat infection one of the great mysteries of medical science is why?
Bacterial infections develop in one case and not another it probably depends on a variety of factors
Such as the strength and number of bacteria and the child's own immune system
However, even if your child doesn't have any symptoms
She can still pass along those resistant bacteria to others
That's how a child who's never even taken antibiotics can become infected with drug-resistant bacteria
young kids in childcare centers share germs better than they share toys says Sarah Long MD a
pediatric infectious disease specialist at Street Christopher's Hospital for Children in
Philadelphia in fact kids play a key role in the development of resistant bacteria
Not only do they spread germs easily?
But they take more antibiotics than adults do while many of those prescriptions are crucial for their health others are
unnecessary
antibiotics are important for treating bacterial infections
But more than 90% of children's illnesses are actually viral infections that can't be cured with antibiotics
Says dr. Long
Asking for antibiotics when your child has a bad cold for example and wind up doing more harm than good
Problems with antibiotics part of the problem is that pediatricians sometimes prescribe antibiotics?
Simply because parents want them to in one CDC study parents walked away with a prescription
65 percent of the time if the doctor thought they expected one but only 12% of the time
Otherwise although some physicians are getting the message. It's still a problem says Lori Hicks
Oh
medical director of the CDC program gets smart know when antibiotics work
Earlier this year the CDC also sent letters to several chain pharmacies
Expressing concern about their programs that were offering customers free generic antibiotics as the solution for colds and flu
Officials worried this would increase pressure on doctors to prescribe antibiotics
Inappropriately, let's face. It as parents
We typically put our child's immediate well-being and sometimes our own need to get back to work ahead of a remote concept like
bacterial evolution if there's a chance
Antibiotics will make our child feel better we may be tempted to take it however
Antibiotic resistance is not a problem. We can worry about tomorrow
Kids are already at risk when they get the following seemingly run-of-the-mill illnesses
So it's important to know when antibiotics don't make sense
Ear infections most ear infections are caused by streptococcus
Pneumoniae a bacterium that can also cause meningitis pneumonia and other infections
Last year a study identified a new strain of strapp dubbed 19a that is resistant to all 18
Antibiotics that are approved by the FDA for use in children kids in the study with those ear infections were
Successfully treated with an antibiotic meant only for adults, but one child suffered permanent hearing loss
Doctors also now realize that mr
Sa can cause your infections as well as skin infections
Drug free treatment since many mild ear infections clear up on their own
Your doctor may recommend a wait-and-see approach
For two to three days if your child is over aged 2 and his infection isn't severe based mostly on the appearance of his
Eardrum you can get a prescription for an antibiotic to fill only if your child doesn't improve
most of my patients parents never fill those prescriptions
Says dr. Hajra Matsu
Smart medicine for a more severe infection your doctor will probably choose an antibiotic based on a established guidelines
Resistance varies regionally if your child is given two rounds of antibiotics within a month and still has an ear infection
There's a good chance the bacteria are resistant says pediatrician Michael pitch s ro MD director of the Rochester
General Hospital Research Institute in New York in that case the American Academy of
Pediatrics recommends an ear tap temp Anacin TSYS
Which is the only way for a doctor to pinpoint the strain of bacteria and find out which antibiotic will kill it?
unfortunately few pediatricians do the procedure which involves putting a needle into a child's eardrum
Temp anna-san tesis was very common when there were only a few
Antibiotics available, but pediatricians are no longer taught how to do it in medical school says dr.
Pitches row I think that will change as more and more
pediatricians are confronted with ear infections
They can't cure with any
Antibiotic an ear tap can also be a form of treatment since it drains infected pus from behind the eardrum
Karen winters of Hilton New York saw the results of an ear tap firsthand with her two-year-old son
Anders who's had several hard-to-treat ear infections he didn't like having us hold him down
But he felt better immediately afterward
She says if your doctor doesn't do the procedure see if you can locate an ear nose and throat
specialist who might otherwise
Your doctor will keep trying different
Antibiotics and may eventually refer your child to have tubes placed in her ears to drain lingering fluid
Inserting timpanist Urmi tubes is now the most common surgical procedure performed on children
It's estimated that nearly seven percent of kids have tubes in their ears by age three
Prevention strategies make sure that your child is fully vaccinated
Ear infections have declined dramatically since the pneumococcal vaccine was first introduced in 2000
Encourage him to wash his hands frequently to avoid catching colds that can lead to ear infections
Urinary tract infections a common infection in young kids you tease are often caused by as Cherokee
Akali bacteria in one recent study of kids with urinary infections
27 percent Haddie Koli that didn't respond to the two most frequently used antibiotics
You tease are most worrisome in babies and toddlers if your child has a fever with no other symptoms. See your doctor right away
drug-free treatment
Skipping antibiotics isn't a good option for a child under age 2 who has a you t because an untreated infection
Can lead to serious kidney damage
That's why pediatricians usually recommend starting treatment
Immediately after diagnosis rather than waiting to see whether a mild infection might resolve on its own
smart medicine
It's important though to take the correct
antibiotic most you DS are diagnosed with an in-office urine test that confirms whether a child has an
Infection but does not identify the specific type of bacteria if the result is positive
your pediatrician will prescribe an antibiotic
to start while you're waiting for the culture results to come back from the lab in a couple of days the lab will identify the
bacteria and send a list of effective
Antibiotics if the drug your child has been taking isn't one of them your doctor should give you a new prescription
And decide whether your child should finish the initial one first
Prevention strategies encourage your child to drink plenty of fluids and use the bathroom frequently
that's the single best way to help prevent urinary tract infections explains max miles MD a
pediatric urologist
at Children's Memorial
Hospital in Chicago
Kids who hold in their urine are at higher risk for
UT's because any germs that reach the bladder have more time to grow before they're flushed away
Also, be sure to teach your daughter to always wipe from front to back
skin infections many types of bacteria cause skin infections
But amara say is making headlines because the multi drug-resistant bacteria can spread to the blood
And lungs and be fatal
hospitalizations for mrs
a nearly tripled between 2000 and
2005 a child can get infected if he happens to have the bacteria on the surface of his skin
And then he gets a bite cut or scrape
Infections can also develop in spots where there hasn't been a visible skin injury like the diaper area
although the bacteria can be spread by
Contaminated objects such as sports equipment experts believe that they're usually transferred from person to person
studies show that between 2 and 10 percent of children carry the
antibiotic-resistant German their nose throat armpits or groin says Rachel Laura Shawn MD a
pediatric infectious disease specialist at st. Louis Children's
Hospital who runs a clinic for children with recurrent amara
Infections three of tina pickets five children have been treated for mrs
A and she assumes that they probably passed it along to each other her two-year-old daughter Macy
Needed surgery and four antibiotics after a mosquito bite became infected her six-year-old son
Dominic had an infection on his bottom and her 13 year old daughter
Brittany needed surgery for a frightening Lee infected spot on her leg it
Started out as a tiny flat red dot and by the next day it had grown to more than 6 inches in diameter
The doctor told me that she was one day away from having her leg amputated or even dying says picket of boda C
Missouri this can happen to anyone my kids had hardly ever been sick before
drug free treatment depending on the severity of the infection
The cure may be as simple as having your doctor drain bacteria containing fluid from the abscess
Smart medicine early detection is key
Look out for a pimple like lesion
That's red swollen tender and seems to get worse rather than better says doctors ray Nevis on
Contact your doctor
Especially if it's accompanied by a fever your pediatrician will probably send a sample of the bacteria to a lab to be
Identified but if he suspects mrs a he should prescribe an antibiotic
Kids with serious cases need oral antibiotics and may even need to be hospitalized for for antibiotics or surgery
Prevention strategies teach your child to wash his hands frequently and to not share items like towels or bar soap
antibiotics are obviously important
Life-saving medications, but resistant bugs are evolving much faster than new drugs are being developed says dr. Long
I've been a doctor for more than 30 years
And it's only in the last five or six years that I've had to tell a family
There is no antibiotic for your child's infection. We have to use antibiotics
Wisely in order to help ensure that they'll continue to work when our children really need them
Related features is it candy or medicine what to do about recurring illnesses?
generation rx
originally published in the May 2009 issue of Parents magazine all
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