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Antibiotics

Get guidelines for treating a sick child, and learn why antibiotics aren't always the answer.

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-Hi, everybody. As a parent, you'll do just about anything to help your child feel better when she's sick. But, sometimes, antibiotics are not the answer. Dr. Alanna Levine, a pediatrician and national spokesperson for the American Academy of Pediatrics, is joining us now with some guidelines when it comes to treating a sick child. It's great to have you back in the studio. -Thanks, Juli. -So, let's start with this. As a pediatrician, what do you tell parents when they come in and they're begging you, "Please give me antibiotics for my child. She's sick." -Well, I'm a parent too. So I understand, your child doesn't feel well and you wanna do something. But what parents need to understand is that antibiotics aren't the quick fix for everything. There's just a difference between something-- an infection caused by a virus and an infection caused by a bacteria, and antibiotics won't work for viral infections. And most of the time when your kid has [unk] viral cough and cold, sniffles, fever, that's caused by a virus and the antibiotics won't help them. -So, let's talk about what antibiotics are effective in treating. -Okay. So if your child has been sick for four or five days, continues to have fever, or complains of ear pain, has a strep throat, ear infections, bronchitis, pneumonia, those are things that antibiotics will help your child for. But general cough and cold medications, they won't help make the illness go away any faster and they won't prevent you from getting a bacterial infection. -Okay, so back to that for a second. -Okay. -We'll touch on it just a bit, the difference between bacterial and viral. I think that's so confusing to parents. -It really is, and most of the time, infections are caused by viruses and they will just go away on their own with time. If an illness lasts more than five or seven days or you see that there's a worsening of symptoms, then you may wanna suspect a bacterial infection and talk to your pediatrician about it. -It's so hard for parents-- -Yes. -who just wanna make their kids feel better. -Right. -They want antibiotics, but we shouldn't always do that. Okay, so if your child has a cold or an upper respiratory infection,-- -Uh-huh. -what kind of symptoms can you expect? -Okay. So, you'll expect a runny nose. You'll expect a cough. Sometimes, a fever or just sort of be tired, cranky. They'll sleep more. Those are things that make parents wanna do something for their children; but, unfortunately, we're sort of limited on what we can do. Good old-fashioned chicken soup, fluids, a humidifier in the room, elevating the head of the bed at night so they can breathe and sleep; those are things that are really effective. -So, when's the time to call, "Dr. Levine,-- -Yeah. -I need to bring in my daughter/my son?" When do you need to do that? -My first rule of thumb is, if you're worried, absolutely call. Don't hesitate. There's no reason for you to sort of spend the night awake, wondering if your child is really sick when you can just call your pediatrician and get advice. Second of all, in my patients, I tell them, "If you have a cough or a cold that lasts more than five days, just come in and let us take a look in the child's ears, let us look at the-- listen to the child's lungs. And if you have a fever that lasts more than four days or five days, definitely come in and talk to us." -And if the fever spikes. -Yeah. You know, I think that a lot of parents are really afraid of the height of the fever. -Uh-huh. -To me, it's really more how your child looks, what's your general impression. Are they lethargic? Are they dehydrated? Those are things that are really more important to me than the number on the thermometer, but when in doubt, just give us a call. -Okay. All right, and now, how about the guidelines? They have changed so much-- -Uh-huh. -for cough medicine and it's not recommended anymore for children under four. -Right. -Tell us about that. -Okay. -Why did they arrive at that point? -First of all, the American Academy of Pediatrics does not recommend the use of cough and cold medications in children at all. The science isn't really behind it. They don't work and they have potential side effects. The FDA kind of came on board with us in 2007 when they really took the infant preparations off the shelves. We really don't like to give cough and cold medications at all in children under age four. Over four, you can use them, but I would do it with caution 'cause really they don't-- they haven't been proven to be that effective. -Okay. So if your child has a cold,-- -Uh-huh. -what do you recommend to parents? What advice would you give? -Well, my own son told me to chop his nose off the last time he had a cold-- -Oh no! -'cause he knew he wasn't getting medications from me-- -It isn't right. yeah. -like that, you know. We didn't go with that option. I really think encouraging lots of fluids and hydration, keeping the air moist with a humidifier. If your child has fever, definitely give a fever reducer like Tylenol or Motrin, warm cup of tea, honey if they're over age two. Those are the things that can be helpful. -Great advice. Now, I know what to do. -There you go. -Well, I'm just gonna call you. -You could do that too. -Dr. Levine, what should I do? Thank you so much for coming and I appreciate it. And for more advice from Dr. Levine, you can go to alannalevinemd.com. Thank you so much for watching Parents TV. We will see you again soon.