A Guide for Parents

Important information

About antibiotics
Antibiotics are among the most powerful and important medicines known. When used properly they can save lives, but used improperly, they can actually harm your child. Antibiotics should not be used to treat viral infections.

Bacteria and viruses
Two main types of germs - bacteria and viruses - cause most infections. In fact, viruses cause most coughs and sore throats and all colds. Bacterial infections can be cured by antibiotics, but common viral infections never are. Your child recovers from these common viral infections when the illness has run its course.

Resistant bacteria
New strains of bacteria have become resistant to antibiotics. These bacteria are not killed by the antibiotic. Some of these resistant bacteria can be treated with more powerful medicines, which may need to be given by vein (IV) in the hospital, and a few are already untreatable. The more antibiotics prescribed, the higher the chance that your child will be infected with resistant bacteria.

How bacteria become resistant
Each time we take antibiotics, sensitive bacteria are killed, but resistant ones may be left to grow and multiply. Repeated use and improper use of antibiotics are some of the main causes of the increase in resistant bacteria. These resistant bacteria can also be spread to others in the family and community.

Protecting your child from resistant bacteria
Learn about the differences between bacterial and viral infections, and talk to your child's doctor about them. Understand that antibiotics should not be used for viral infections.

When are antibiotics necessary?

This complicated question is best answered by your doctor, and the answer depends on the specific diagnosis. This chart can help you remember when antibiotics are necessary, and when they are not necessary:

Illness	Usual Cause of infection		Antibiotic Needed?	Comments
Illness	Virus	Bacteria	Antibiotic Needed?	Comments
Common Cold Head Cold	Yes	-	NO	Only viruses cause colds and the flu. Antibiotics won't cure cure these illnesses. Ask your doctor to suggest ways to ease your child's comfort until the infection runs its course.
Flu (influenza)	Yes	-	NO
Runny nose with green or yellow discharge	Yes	-	NO	Colored discharge is a normal part of sickness and indicates the virus is being killed.
Cough or Bronchitis (Chest cold)	Yes	-	NO	Children rarely need antibiotics for a cough or bronchitis.
Middle Ear Infection	Yes	Yes	Sometimes	Several types exist; some need antibiotics and some do not.
Sinus Infection	Yes	Yes	Sometimes	Antibiotics are needed for some long-lasting or severe cases.
Sore Throat	Yes	Yes	Sometimes	Most are caused by viruses. Only strep throat requires antibiotics. This must be diagnosed by a laboratory test.

When to call your doctor

Viral infections may sometimes lead to bacterial infections. But treating viral infections with antibiotics to prevent bacterial infections does not work, and may lead to infection with resistant bacteria. Keep your doctor informed if the illness gets worse or lasts a long time, so that proper treatment can be given, as needed.

Call your child's doctor or health professional:

When your child is less than 3 months old and has a fever or is acting sick.
When your child has difficulty breathing or swallowing.
When your child has a cough for more than 10-14 days and isn't getting better.
When your child has a yellow or green mucous from the nose for more than 10-14 days and isn't getting better.
When your child has a fever and a rash.
When your child has a fever and ear pain.

Frequently asked questions

What can I do to protect my child from antibiotic-resistant bacteria?

Use antibiotics only when your doctor has determined that they might be effective. Antibiotics will not cure runny noses, colds, coughs, or most sore throats - children fight off colds on their own. Hand washing with soap and water for 10-30 seconds is another important way to protect your child. Don't forget to wash your hands after being in public places, before eating all meals, and after direct contact with others.

If mucus from the nose changes from clear to yellow or green, does this mean that my child needs an antibiotic?

Yellow or green mucus does not mean that your child has a bacterial infection. It is normal for the mucus to get thick and change color during a viral cold.

Does this mean I should never give my child antibiotics?

Antibiotics are very powerful medicines, and should be used to treat bacterial infections. If an antibiotic is prescribed, make sure you take the entire course as your doctor prescribed. Never save antibiotics for later use.

How do I know if my child has a viral or bacterial infection?

Ask your doctor or healthcare provider. If you think that your child might need treatment, you should contact your doctor. But remember, colds are caused by viruses, and should not be treated with antibiotics.

If my child is sick, can my child go to daycare or school?

Your child does not create a risk to others when he or she has a viral infection. When a child has a viral infection, he or she has likely been exposed at school and has been contagious to others before ever showing signs of illness. Taking your child out of school or daycare will allow them to rest and recover while receiving close parental attention. Teachers and daycare providers may not have sufficient time to care for ill children as well as the other children in their care.

Does taking my child to daycare increase his/her risk of getting an antibiotic strain?

When your child is in a daycare setting, he or she is in contact with many other children. Because viruses are very common among children, this increases his or her risk of contracting any kind of infection, but mostly viral infections.

Source: Centers for Disease Control and Prevention: Your Child and Antibiotics (1997).