Seeing your child sick and struggling with an illness can be pretty upsetting.  As a parent, you may often wonder whether antibiotics are needed. As much as you want to ease their pain and discomfort, giving your child the proper treatment is paramount. Dr. Christina Dewey, a mom of two and pediatrician at Blueberry Pediatrics, sheds light on when antibiotics are necessary and how to use them responsibly. 

What are antibiotics?

Antibiotics are medications designed to combat bacterial infections by killing or preventing their multiplication. They are a vital tool in modern medicine and have saved countless lives. However, antibiotics can also cause side effects and contribute to the rising issue of antibiotic resistance.

Are antibiotics effective?

Antibiotics are effective against bacterial infections but do not help treat viral infections like colds or the flu. Most common childhood illnesses, such as ear infections, coughs, and sore throats, are caused by viruses. Giving antibiotics for these conditions will not help your child improve quickly, and may cause uncomfortable side effects such as diarrhea. Because of their side effects, pediatricians usually won't prescribe antibiotics unless they are very sure they are required.

When are antibiotics necessary?

It is essential to consult with your pediatrician before starting any antibiotic treatment. Your doctor will be able to assess whether your child's symptoms indicate a bacterial infection or if antibiotics would be a beneficial part of treatment.

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Five reasons your child might need antibiotics

Strep throat 

Children often complain of a sore throat at the start of many illnesses.  While viruses cause most sore throats, sometimes bacteria can cause throat infections, the most common of which is “strep throat” caused by Group A Streptococcus (GAS) bacteria.  Signs of strep include abrupt onset of fever, sore throat, and headache; abdominal pain and vomiting may also occur.  A throat swab test is needed to determine if your child has strep throat.  If positive, your child needs treatment with an antibiotic to feel better and to prevent complications associated with untreated strep infection.

Severe ear infection 

Most ear infections are due to viruses, over half of which will resolve independently without any specific intervention. Bacteria can cause some ear infections, most commonly Streptococcus pneumoniae, non-typeable Haemophilus influenzae, and Moraxella catarrhalis.  To diagnose a severe ear infection, your child’s doctor needs to visualize their eardrum. If you’re a Blueberry Pediatrics member, we ask you to use our otoscope to take and send in ear videos! 

Signs an ear infection may need antibiotics include bulging of the eardrum, purulent fluid, fever, ear pain, or perforation of the eardrum with fluid draining from the ear.  Some children are at increased risk of severe ear infections, including infants less than six months of age, immunocompromised children, extremely ill-appearing children, and children with craniofacial abnormalities (cleft palate), and we are more likely to treat these children with antibiotics more quickly. 

Worsening or ongoing cough

Coughing is a very common symptom of illness and most often is due to a viral infection, allergies, and/or sometimes asthma.  If your child has been coughing for longer than two weeks, has a high (>101.5F) fever, chest pain, pain with coughing, is breathing very fast, is unable to talk/complete a sentence, is coughing and vomiting, or non-stop coughing, they need to be evaluated in person by their pediatrician to determine if an antibiotic or other medication is needed.  Additionally, if your child’s oxygen level is <93% using the pulse oximeter, they need to be seen asap. 

Ongoing sinus pain 

During an upper respiratory infection or a cold, many children/teens will experience sinus pain/pressure.  They may complain of headache, face pain, pain when bending over, teeth pain, or pain when tapping on their face under their eyes or over their eyebrows.  Most of the time, these symptoms will improve after treatment with pain relievers such as acetaminophen (Tylenol) and/or ibuprofen (Motrin/Advil).  If your child’s pain is not relieved by pain meds, lasts longer than two weeks, or is accompanied by an ongoing fever (>101.5F), or if they develop red eyes/conjunctivitis with eye drainage, they may need treatment with antibiotics for a bacterial sinus infection.  Please note: nasal drainage can be many colors - shades of yellow, green, brown, and even bloody - and the color of drainage does NOT mean they have bacterial infection.

Pink eye (conjunctivitis) 

The most common cause of red eyes in children is viral infection, and as stated earlier, viral infections do not need to be treated with antibiotics.  However, children often rub their eyes and can develop a bacterial superinfection.  Bacterial eye infections often have purulent (yellow/green) drainage, and antibiotics are recommended to help clear infections more quickly.  If your child has watery clear eye discharge, it’s likely viral.  If the eye discharge is white/stringy - allergies are likely the cause.  Sinus infections can also cause red eyes with purulent discharge, and ear infections often occur with conjunctivitis too!  The best way to know if your child needs antibiotic treatment for their eyes - contact us or your child’s pediatrician!

Get Guidance from Blueberry Pediatrics

If you suspect your child has a bacterial infection or have more antibiotic questions, you can chat with a board-certified pediatrician through Blueberry Pediatrics.

Blueberry offers on-demand virtual healthcare for kids ages 0-21, right from the comfort of home. Blueberry's pediatricians are available 24/7/365 through text, video, or call. We treat most childhood symptoms and illnesses; no question is too big or small.

The best part? An entire year of Blueberry membership costs less than the typical copay of a single urgent care visit, and one membership covers all children in your household! It's like a doctor's office in your house. Sign up here.