Antibiotics for “Just in case”?

Approximately 200,000 children (17 years old or younger) visit emergency departments each year because of adverse drug events. Children less than 5 years old are more likely than older children to visit the emergency department for an adverse drug event. To avoid adverse events it is imperative that children not take medications unless necessary and that any prescribed medication for your child is given as prescribed. 

The Center for Disease Control (CDC) is spearheading a national effort to improve antibiotic prescribing and use. Overuse of antibiotics is one of the biggest public health challenges of our time. Each year in the U.S., at least 2.8 million people get an antibiotic-resistant infection, and more than 35,000 people die. Improving antibiotic prescribing and use is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antibiotic resistance.

Despite the CDC recommendations, antibiotics are commonly overprescribed. In a busy practice or emergency room antibiotics, steroids and other medications are frequently prescribed for a diagnosis regardless of severity.  It is not uncommon to be  given medications '“just in case” the symptoms worsen.

Especially in busy emergency rooms, it is often easier and quicker to hand someone a prescription. They may not have time to sit down and explain why the medication is likely not needed at this time  and at what time they may be needed.  The ER physician may attempt to cover all the bases since they are not the patients regular doctor and may not see them again. 

Antibiotics when indicated may be life saving. Antibiotics may be necessary at times to fight off serious bacterial infections, but should be used judiciously. Unfortunately they are often used excessively especially in children . If we want them to work when we need them, we must only use them if clearly indicated. Not only can antibiotics overuse cause resistance to the bacteria they are intended to treat, they are harmful to our good bacteria which help our immune system,.

In addition to killing bad bacteria, antibiotics kill the healthy bacteria in our gut. We now know how important healthy bacteria in our gut is to our immunity and overall health. If you must take an antibiotic, replenish the healthy bacteria by taking probiotics in foods or supplements and get lots of plant foods which provide the prebiotic or healthy environment for the good bacteria to live. 

Antibiotics may also cause allergic reactions which may be life threatening. They can cause decreased blood counts.They often cause GI distress, vomiting, diarrhea, and rashes in addition to an endless list of possible other side affects. 

Viral infections do not normally need to be treated with antibiotics. To help us fight off viral illness we may do things to support our immune system before and during an infection. Before an infection, put in the work by  creating a healthy gut microbiome. This is done by eating a high fiber plant based diet and avoiding medications that alter the microbiome. In addition exercise, adequate rest and hydration are necessary for proper immune health.

During an infection rest and hydration and proper diet are still key but other things that may support immune function are vitamins and minerals and herbal remedies. Studies have found evidence that supplemental zinc, echinacea, vitamin C and  probiotics can help fight infection. There have been few herbal or supplement studies done in children but have been safely used. Find an herbalist who works with children or reference Herbal Remedies for Children’s Health by Rosemary Gladstone.

In general it is not recommended to take antibiotics “just in case”. The negative consequences are often more dire than any positive. Work on supporting an optimal state of wellness so that you have a strong immune system. When ill take the time to rest and recuperate. If a previously diagnosed viral illness takes a turn for the worse, your child should be reevaluated.