Smart Medicine: Preventing Overuse of Antibiotics

Skin Infections

Many types of bacteria cause skin infections, but MRSA is making headlines because the multidrug-resistant bacteria can spread to the blood, joints, and lungs -- and be fatal. Hospitalizations for MRSA 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 germ in their nose, throat, armpits, or groin," says Rachel Orscheln, MD, a pediatric infectious-disease specialist at St. Louis Children's Hospital who runs a clinic for children with recurrent MRSA infections.

Three of Tina Pickett's five children have been treated for MRSA, and she assumes that they probably passed it along to each other. Her 2-year-old daughter, Macy, needed surgery and IV antibiotics after a mosquito bite became infected, her 6-year-old son, Dominic, had an infection on his bottom, and her 13-year-old daughter, Brittney, needed surgery for a frighteningly 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 six inches in diameter. The doctor told me that she was one day away from having her leg amputated or even dying," says Pickett, of Potosi, 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 Dr. Arjun Srinivasan, MD, a medical epidemiologist at the Centers for Disease Control and Prevention (CDC). 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 MRSA, he should prescribe an antibiotic. Kids with serious cases need oral antibiotics and may even need to be hospitalized for IV antibiotics or surgery.

Prevention strategies

Teach your child to wash his hands frequently and to not share items like towels or bar soap.

The Final Word

Antibiotics are obviously important, lifesaving 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.

Originally published in the May 2009 issue of Parents magazine.

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