It is necessary to treat children with antibiotics in the following diseases:
- rhinitis;
- bronchitis;
- otitis;
- pneumonia.
Unfortunately, there are no reliable external signs or simple and cheap laboratory techniques to distinguish between the viral and bacterial origin of respiratory tract infections. At the same time, it is known that acute rhinitis and acute bronchitis are almost always caused by viruses and tonsillitis, acute otitis and sinusitis in most cases — by bacteria.
It would appear reasonable that the approaches to antimicrobial therapy of individual acute upper respiratory tract infections should differ.
Rhinitis and Bronchitis
Antibiotics are not prescribed for treating acute rhinitis and bronchitis (what is bronchitis). The practice has shown that parents usually do not give their child anti-infective drugs during first days of high temperature and cough. But then they begin to fear that bronchitis may have complications and turn into pneumonia, and decide to use antibiotics. It is worth mentioning that such complications are possible, but it almost doesn’t depend on the preceding anti-infective drugs intake. The main signs of pneumonia are the recrudescence (a further increase in body temperature, increased cough, dyspnoea). In this case, parents should immediately call a doctor who will decide whether the treatment should be changed.
If the condition is not recrudescing but does not essentially improve, there is no apparent reason to use anti-infective drugs. However, some parents during this period just give up and begin to give their children antibiotics «just in case».
Most significantly is that a very popular reason for anti-infective drugs prescribed for treating viral infections – high temperature doesn’t decrease within 3 days — is absolutely groundless. The natural duration of febrile state during viral respiratory tract infections in children considerably varies, from 3 to 7 days and sometimes even longer. If the so-called subfebrile temperature (37,0 – 37,50 degrees C) doesn’t decrease for quite a long time it doesn’t necessarily linked to bacterial exacerbation development and may be explained with completely different reasons. In such cases, the use of antibiotics is useless.
A typical sign of viral infection is a continuous cough on the background of general state improvement and body temperature normalization. Keep in mind that antibiotics are not antitussive drugs. Parents in such situation have a wide range of traditional antitussive remedies to apply. Coughing is a natural defense mechanism, and it is the last of all the symptoms to subside. However, if your child has an intense cough during more than 3-4 weeks, it is necessary to look for its cause.
Otitis
In treating acute otitis antibiotic therapy is different, since the probability of bacterial origin of the disease reaches 40-60%. Considering that, until recently antibiotics were prescribed to all patients.
As practice has shown, acute otitis is characterized by intense pain during the first 24-48 hours, then the majority of children’s state significantly improves and they recover without any medicaments. After 48 hours period symptoms remain only in third part of the patients. An interesting research shows that if all children with acute otitis take antibiotics they will give some help (shortening of febrile and pain duration period), but only to those patients who would not have recovered without drugs. It may be only 1 child out of 20.
As in the case of bronchitis, the appointment of antibacterial drugs to treat otitis does not prevent suppurative complications appearance. Complicated otitis forms are observed with equal frequency in children who took and didn’t take antibiotics.
Nowadays, a new anti-infective drugs prescription method in acute otitis is developed. It is reasonable to prescribe antibiotics to all children under the age of 6 months, even if there are doubts about the diagnosis. At the age from 6 months to 2 years with a questionable diagnosis (or mild course) antibiotics intake may be delayed. First, it’s desirable to observe a child. During this observation period, children should take anesthetic medications and, if necessary, febricides. These and other medicaments may be found in Canadian Health&Care Mall online for the reasonable price. If within 24-48 hours the condition does not improve, you need to start antibiotic therapy.
Pneumonia
In case of pneumonia antibiotic therapy method differs from the two previously described cases.
Certain age groups of children are characterized with some predominant pathogens specific features. Thus, in the age of 5-6 years, according to some researchers, up to 50% of pneumonia cases can be caused by viruses. At an older age, the probability of viral origin of pneumonia is significantly reduced and the role of bacteria (pneumococci) in pneumonia development increases. However, in all age groups common cause of this disease is pneumococcus, which causes the severe course of the disease. That is why pneumonia is an absolute reason for antibiotic therapy.
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