Principles of antibiotics prescription
Antibiotics is a group of natural or semi-synthetic organic compounds capable of destroying microbes or inhibit their reproduction.
Antibiotics are used for infections caused by bacteria. In a hospital with severe and life-threatening infectious diseases (such as meningitis – an inflammation of the meninges, pneumonia, etc.) responsibility for the correctness of the drug choice lies entirely on the doctor, who takes the observation data of the patient (a clinical picture) and the special studies results into account.
When light infections occurring in the “home” (outpatient) conditions, the situation is fundamentally different. The doctor examines the child and prescribes the medication, sometimes he gives explanations and answers to questions, sometimes – he does not. Often, parents ask doctors to prescribe antibiotics. Sometimes, it’s easier for pediatricians to write a prescription in such situations, than to risk their reputation and spend time explaining inappropriate purposes of such treatment.
In any case, the physician should follow two basic principles of antibiotic therapy:
- Prescribe the most effective drugs in cases where their effect is proved;
- minimize antimicrobial drugs in all other cases.
Unfortunately, there are no reliable external signs or simple and cheap laboratory techniques to distinguish between viral and bacterial origin of respiratory tract infections. At the same time it is known that acute rhinitis (runny nose) and acute bronchitis (inflammation of the mucous membrane of the bronchi) are almost always caused by viruses, and tonsillitis (inflammation of the tonsils and throat), acute otitis media (ear infection) and sinusitis (inflammation of the mucosa of the paranasal sinuses) in a large part of cases – by bacteria.
It is logical to guess that the approaches to antibiotic therapy of separate acute upper respiratory tract infections should be different.
Antibiotics for Children: Runny Nose and Bronchitis
Canadian Family Pharmacy antibiotics are not prescribed in the cases of acute rhinitis (runny nose) and bronchitis. In practice, the situation develops in the following way: the child has high temperature and cough one or two days, and the child’s parents usually do not give the baby antibiotics. But then they start to fear that bronchitis is complicated with pneumonia, and decide to use antibiotics. It is worth noting that this complication is possible, but almost does not depend on the preceding antimicrobials’ intake.
The main signs of pneumonia:
- High body temperature;
- increased cough;
In such a situation parents should immediately call a doctor who will decide whether the treatment with antibiotics should be corrected or not.
If the condition is neither deteriorating, nor improving, there is no apparent reason for antibacterial drugs prescription. However, some parents just give up in this period and begin to give children drugs “just in case”.
We should note that a very popular criterion of antibacterials prescription in cases of viral infections – a high temperature within three days – is absolutely groundless. The natural duration of febrile period for viral respiratory tract infections in children varies considerably – from 3 to 7 days, and sometimes longer. Longer preservation of so-called low grade temperature is not necessarily linked to the development of bacterial complications, and may happen due to very different reasons. In such situations, the use of antibiotics is doomed to failure.
A typical sign of a viral infection is persisting cough along the improvement of general condition and normalization of body temperature. Keep in mind that Canadian Family Pharmacy antibiotics are not antitussives. Parents in this situation have great opportunities for the application of folk antitussives. Coughing is a natural defense mechanism and disappears the last of all the disease symptoms. However, if your child has an intense cough longer than 3-4 weeks, it is necessary to look for the cause.
Antibiotics for Children: Otitis
In the case of acute otitis, tactics of antibiotic therapy are different, as the probability of bacterial origin of the disease reaches 40-60%. Taking this fact into account, earlier antibiotics were prescribed to all patients.
As Canadian Family Pharmacy practice shows, acute otitis media is characterized by intense pain during the first 24-48 hours, then the majority of children feel significant improvement and the disease retreats. 48 hours later the symptoms remain only in one third of young patients. There are interesting calculations showing that if antibiotics are given to all children with acute otitis, they will help (short febrile period and duration of the pain), only those patients who should not have experienced an independent speedy recovery. That may be only 1 child out of 20.
What will happen to the rest of the 19-th children? When you take modern drugs of penicillin group, such as amoxicillin or augmentin, nothing really bad can happen. 2-3 children may develop diarrhea or skin rashes, which rapidly disappear after cessation of treatment, but recovery will not be accelerated. As with bronchitis, antibacterial drugs in case of otitis do not prevent development of septic complications. Complicated forms of otitis develop with the same frequency as in children who taken and have not taken antibiotics.
At the moment, a new tactic of antibacterial drugs prescription for acute otitis is developed. Antibacterials should be prescribed to all children under the age of 6 months, even in the case of doubtful diagnosis of acute otitis (it’s not so easy to find out that a child suffers from ear pain).
At the age of 6 months to 2 years antibiotics can be delayed in a case of a questionable diagnosis (or less severe) of acute otitis, limiting to the supervision of a child. Naturally, children should be given pain medication and, if necessary, antipyretics during the observation. If their condition does not improve within 24-48 hours, you need to start the antibiotic therapy. Before you start the treatment with antibiotics, study antibiotics side effects and other important information.
If a child has signs of pneumonia, it’s necessary to:
- Discuss with your doctor when to give antibiotics;
- clarify what signs of the disease you should pay attention to;
- evaluate the dynamics of the pain, its enhancement or reduction, and to notice the new symptoms of the disease in time.
Parents should be able to contact the doctor on the phone and have an available prescription for an antibiotic.
For children over the age of 2 waiting and watching for 48 hours is the preferred tactic, except the cases of a heavy disease flow (very high temperature, intense pain).
Antibiotics for Children: Pneumonia
Tactics of antibiotic therapy differs from the two previous cases, if a child is diagnosed with pneumonia or has serious suspicion of this pathology.
Some pathogen features are characteristic for this case. Thus, according to some researchers, 50% of 5-6-years-old children develop pneumonia due to viruses influence. Older children have a lower probability of viral pneumonia; the role of bacteria (pneumococci) in the development of pneumonia is also reduced. However, Streptococcus is a common cause of this disease among all age groups; this virus causes a severe course of the disease. That is why pneumonia is an absolute indication for antibiotic therapy. More details about prescription of antibiotics to children at choosingwisely.org.
Yoy may buy the best Canadian Family Pharmacy antibiotics online: Amoxicillin, Zithromax, Cipro, Flagyl, Bactrim and others.
There are natural antibiotics that can not substitute the chemical, but can help protect the body from many infections. Unlike synthetic antibiotics, natural ones do not weaken, but strengthen the immune system. In addition, they do not affect micro flora. There are a lot of plants and products with antibacterial and anti-inflammatory properties. The most popular of natural antibiotics accessible to everyone: garlic, onion, horseradish, raspberry, cranberry, pomegranate, honey, chamomile.
You should be very careful giving your children antibiotics. Consult a doctor and purchase the medications only in reliable pharmacies and order antibiotics online – all the necessary drugs on the beneficaial conditions. Be healthy!