Why Is My Doctor Not Giving My Child Antibiotics?

Well it’s that time of year again! Along with the pumpkins, turkeys and a pleasant breeze and cooler weather, we will of course start to see the runny noses, sore and scratchy throats and pesky coughs. As adults, we may get around 2-4 colds a year, but younger kids can get as many as one per month, especially this time of year! When kids are miserable, we want to do everything we can to make them feel better. You may wonder then, “Why isn’t my doctor giving my child antibiotics?”

Antibiotics are a group of medicines which work to kill bacteria in different ways. Sometimes illnesses are caused by bacteria, but a lot of the time, they are not caused by bacteria but by viruses. In fact, the common cold, or an acute upper respiratory tract infection (URI), is the most common cause of illness in humans, and is caused by many different types of viruses, and not bacteria. The symptoms these viruses cause are self-limited, meaning they only last for so long, usually from 5 days all the way to 2 weeks, and our own bodies do a good job of killing the virus ourselves.

Giving antibiotics to a child who has a viral infection is not a good idea, for three main reasons:

1. Antibiotics will not work if there isn’t a bacterial infection. Antibiotics only work by killing the bacteria which is causing the problem. If bacteria aren’t causing the problem, then they will not help at all.
2. Antibiotics can cause more problems for your child and doctors want to avoid this if your child doesn’t need them. In our bodies we have a lot of good bacteria that help to keep us healthy. An unfortunate side effect of antibiotics to treat bad bacteria is that oftentimes they can kill good bacteria too. In fact, one recent study estimated that more than 60,000 children a year go to the emergency room for antibiotic-related side effects!* One of the most common side effects of antibiotics is diarrhea, along with nausea and upset stomach. So if antibiotics aren’t going to help, we try not to give them so we can avoid any of these side effects.
3. Finally, we know when we overuse antibiotics, we increase the risk that in the future these antibiotics may stop working when we need them. This is called antibiotic resistance – when the bacteria learn how to protect themselves from the antibiotics, and the antibiotics don’t work anymore. Antibiotic resistance is a growing problem all across the world, and we want to make sure we save our antibiotics for when we really need them.

Just because we don’t give a specific medicine, that doesn’t mean you can’t do things to help your child! Instead of asking your doctor for a medication this cold season, ask them for tips on how to make your child feel better. Remember we also don’t recommend over-the-counter cough and cold medicines for children under 6 years of age.

So this cough and cold season, remember antibiotics are not always the right answer!

*Lovegrove, Maribeth C., et al. "US Emergency Department Visits for Adverse Drug Events From Antibiotics in Children, 2011–2015." Journal of the Pediatric Infectious Diseases Society (2018).