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When does your child need antibiotics?

Published in Pediatrics, For the Health of It Author: Ulrika Wigert,MD

Some parents think that every time their child has a sore throat, cough or runny nose, their child needs antibiotics.

If your child has a bacterial infection, antibiotics may help. But if your child has a virus, antibiotics will not help your child feel better or keep others from getting sick. A lot of parents think that having yellow or green mucus is a sign of a bacterial infection — that’s not true.

Antibiotics fight bacteria — not viruses

  • Most colds and flus are viruses.
  • Chest colds, such as bronchitis, are also usually caused by viruses. Bronchitis is a cough with a lot of thick, sticky phlegm or mucus.
  • Most sinus infections (sinusitis) are from viruses with a lot of mucus in the nose and post-nasal drip.
  • Many common ear infections clear up on their own without antibiotics.
  • Most children with sore throats (symptoms include fever, redness and trouble swallowing) do not have strep throat. Your child should have a strep test and the doctor will prescribe antibiotics if needed. Strep throat is a bacterial infection.

Side effects

Antibiotics can cause diarrhea or vomiting. About five percent of children are allergic to antibiotics.

Overusing antibiotics also encourages the growth of stronger bacteria that does not respond to antibiotics. So the next time your child has a bacterial infection, the antibiotics will not work as well. The stronger bacteria can spread from your child to other family members and friends, causing infections that are more difficult to cure and more costly to treat.

Antibiotics may be needed if your child has:

  • A cough does not get better in 14 days.
  • A bacterial form of pneumonia or whooping cough (pertussis) is diagnosed.
  • Symptoms of a sinus infection do not get better in 10 days, or they get better and then worse again.
  • Yellow-green nasal discharge and a fever of at least 102° F for several days in a row.
  • Strep throat, based on a rapid strep test or a throat culture.