Dangers of Antibiotic Overuse

Every year, your family probably faces its share of colds, sore throats, and flus. When you bring your child to the doctor for these illnesses, do you automatically expect a prescription for antibiotics?

Many parents do. And they're surprised, maybe even angry, if they leave the doctor's office empty-handed - after all, what parent doesn't want their kid to get well as quickly as possible? But your child's doctor could be doing you and your child a favor by not reaching for the prescription pad.

How Do Antibiotics Work?
Antibiotics, first used in the 1940s, are certainly one of the great advances in medicine. But overprescribing them has resulted in the development of bacteria that don't respond to antibiotics that may have worked in the past. Plus, a child who takes antibiotics when it isn't necessary runs the unnecessary risk of adverse reactions, such as stomach upset and diarrhea.

To understand how antibiotics work, you have to understand the two types of germs that can make your child sick: bacteria and viruses. Although certain bacteria and viruses cause diseases with similar symptoms, the ways these two organisms multiply and spread illness are actually quite different.

Bacteria are living organisms existing as single cells. Bacteria are everywhere and most don't cause any harm, and in some cases may be beneficial. Lactobacillus, for example, live in the intestine and help digest food. But some bacteria are harmful and can cause illness by invading the human body, multiplying, and interfering with normal bodily processes. Antibiotics are effective against bacteria because they work to kill these living organisms by stopping their growth and reproduction.
Viruses, on the other hand, are not alive and cannot exist on their own - they are particles containing genetic material wrapped in a protein coat. Viruses "live," grow, and reproduce only after they've invaded other living cells. Some viruses may be fought off by the body's own immune system before they cause illness, but others (colds, flu, and chicken pox, for example) must simply run their course. Viruses do not respond to antibiotics at all.
Why It's Harmful to Overuse Them
Taking antibiotics for colds and other viral illnesses not only won't work, but it also has a dangerous side effect: over time, this practice helps create bacteria that have become more of a challenge to kill. Frequent and inappropriate use of antibiotics selects for strains of bacteria that can resist treatment. This is called bacterial resistance. These resistant bacteria require higher doses of medicine or stronger antibiotics to treat. Doctors have even found bacteria that are resistant to some of the most powerful antibiotics available today.

Antibiotic resistance is a widespread problem, and one that the U.S. Centers for Disease Control and Prevention calls "one of the world's most pressing public health problems." Bacteria that were once highly responsive to antibiotics have become increasingly resistant. Among those that are becoming harder to treat are pneumococcal infections (which cause pneumonia, ear infections, sinus infections, and meningitis), skin infections, and tuberculosis.

Taking Antibiotics Safely
So what should you do when your child gets sick? To minimize the risk of bacterial resistance, keep the following tips in mind.

Treat only bacterial infections. Seek advice and ask questions.
Letting milder illnesses (especially those thought to be caused by viruses) run their course to avoid the development of drug-resistant germs may be a good idea - but it's still best to leave what constitutes a "mild illness" up to your child's doctor. Even if your child's symptoms don't worsen, but continue to linger, be on the safe side and have him or her checked out. At the office, ask questions about whether your child's illness is bacterial or viral, and discuss the risks and benefits of antibiotics. If it's a virus, don't pressure your doctor to prescribe anyway. Ask your doctor about ways to treat symptoms.
Use antibiotics as prescribed.
Don't save antibiotics for next time.
Never use another person's prescription.
Ask your child's doctor about ways to treat the symptoms that are making your child uncomfortable, such as a stuffy nose or scratchy throat, without the use of antibiotics. The key to building a good relationship with your child's doctor is open communication, so work together toward that goal.

Use the medication properly. Antibiotics are only effective if taken for the full amount of time prescribed by the doctor - and they take time to kick in, too, so don't expect your child to feel better after taking the first dose. Most children take 1 to 2 days to feel a lot better. Similarly, don't let your child take antibiotics longer than prescribed.

And most important, never use antibiotics that have been lying around your home. Never take antibiotics that were prescribed for another family member, either - doses for children vary, and if your child did have an illness requiring antibiotics, you'd want to make sure you were treating it correctly. Saving antibiotics "for the next time" is a bad idea, too. Any remaining antibiotic should be thrown out as soon as your child has taken his or her full course of medication.

Help fight antibiotic resistance by taking simple steps to prevent the spread of infections. Encourage hand washing, make sure your child is up to date on immunizations, and keep your child out of school when sick.

Doctors are aware of increasing antibiotic resistance and are trying to solve the problem. New antibiotics may be on the horizon, but for now antibiotics need to be prescribed and used appropriately.

Reviewed by: Mary L. Gavin, MD
Date reviewed: July 2005