How and when to use antibiotics

Antibiotics are powerful tools against infection. But they’re often overused, and their overuse can lead to more health problems in the long run.

Two major types of infection exist: bacterial and viral. Antibiotics are useful in treating bacterial infections. But 90 percent of illnesses among children are caused by viral infections, which antibiotics can’t combat.

Too often, antibiotics are dispensed for viral infections and have no effect. The Centers for Disease Control and Prevention (CDC) notes that millions of courses of antibiotics are dispensed each year for viral upper respiratory infections that would have resolved on their own without antibiotics.

Why overuse of antibiotics matters

Overusing antibiotics can lead to antibiotic resistance and the emergence of drug-resistant bacteria commonly called “superbugs.”

Our bodies have colonies of bacteria, both beneficial and harmful. Some of these bacteria are naturally resistant to certain antibiotics. When we take those antibiotics, they kill off susceptible bacteria, leaving resistant strains to flourish in our bodies. If they’re harmful, their antibiotic resistance makes them extremely hard to treat, which is why they’re called superbugs.

What you can do instead of giving antibiotics 

Depending on your child’s symptoms, nonprescription remedies may be a better alternative. These include rest, lots of fluids, a cool-mist vaporizer, saline nose spray, ice chips, or some combination of these. They may provide some relief while you wait for your child’s immune system to fight the virus he’s acquired.

The CDC provides parents with the following tips on antibiotics: 

  • Don’t demand antibiotics from your child’s health care provider. 
  • Don’t give your child an antibiotic for a viral infection like a cold or most sore throats. 
  • Don’t take antibiotics prescribed for someone else. 

When to use antibiotics 

Antibiotics are effective against bacterial infections like strep throat and some ear infections. Signs that your child’s illness may be bacterial include a high fever (above 104°F) and persistent symptoms lasting 10 days or more. 

However, complications can develop more quickly in younger children, so if your child is younger than age 2 and has severe symptoms, don’t wait 10 days to get treatment! If your child has any of the following symptoms or if any of the following conditions apply, you should take her to a health care provider right away:

  • fever lasting more than 3 days
  • history of contact with someone diagnosed with strep throat
  • trouble breathing or shortness of breath
  • blood or pus in his mucus or saliva
  • discharge from her ears
  • unwillingness to take in fluids

How to use antibiotics effectively

Antibiotics can only work properly if they are used correctly so it's important to...

  • Give every dose of antibiotic as directed, especially when your child throws up. If your child vomits immediately after taking the antibiotic and you’re able to tell that all the medicine has been thrown up, you may be cleared to administer a second dose right away. But check with your baby’s health care provider first. To avoid triggering your child’s gag reflex (which happens when there’s contact with the middle of the tongue), use a syringe to dispense the medicine slowly along the inside of the cheek. If your child continues to throw up her medicine, seek additional guidance from your health care provider.
  • Don’t skip doses. Follow through with the dosages as directed, and complete the full regimen. 

  • Ask your child's health care provider if there are any foods or vitamins that should be avoided. For example, grapefruit juice and dietary supplements containing minerals like calcium may weaken the effect of antibiotics.
  • Discard any extra medicine. Antibiotic prescriptions for children tend to include a little extra because children often throw up their medications. So finish only the prescribed regimen. If some medication is left in the bottle, throw it away. Also, don’t give the medication to another child even if that child has the same symptoms. 

How to deal with antibiotic side effects 

Many antibiotics have side effects, but these are short term and clear up when the medicine is stopped. These may include mild diarrhea, stomach upset, nausea, and headaches. But if these effects are moderate to severe, contact your child’s health care provider for guidance. The doctor may recommend stopping the medication or suggest that parents continue the treatment while addressing the side effects.

And if your child experiences a severe allergic reaction—like hives, trouble breathing, or vomiting—stop the medication right away and get immediate medical attention for your child. These symptoms can indicate life-threatening anaphylaxis. Once your child’s condition has been stabilized, contact your health care provider. The provider may then prescribe a different antibiotic or a different course of treatment.

Last updated July 7, 2019

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