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When Do We Need Antibiotics: Myths and Facts

Posted on Nov 10, 2020

The chart shows examples of when antibiotics are and are not needed.

Antibiotics are a major tool in treating illnesses caused by bacteria, but like any tool, they need to be used appropriately or they may not work when we really need them due to antibiotic resistance. Antibiotics should only be used to treat bacterial infections and are not effective in curing viral infections.

The Centers for Disease Control and Prevention reports that at least one-third of pediatric antibiotic prescriptions are unnecessary. As we head into cold and flu season during the COVID-19 pandemic, David Berman, D.O., FAAP, FPIDS, a pediatric infectious disease specialist at Johns Hopkins All Children’s Hospital, clears the air on some myths and facts on antibiotics as we get closer to U.S. Antibiotic Awareness Week, Nov. 18-24.

FALSE: Certain antibiotics can help with COVID-19 symptoms.

COVID-19 is a virus and will not respond to antibiotics. Your pediatrician will determine the best treatments based on the severity of your child’s coronavirus symptoms. Many children can be treated at home, while others may have to be hospitalized. However, antibiotics will not be a course of treatment unless a secondary bacterial infection occurs along with COVID-19.

FALSE: If you have green or yellow mucus, it's a bacterial infection and you need antibiotics.

Colds, sore throats, upper respiratory infections and influenza (the flu) are caused by viruses, which could cause colored mucus. Antibiotics won’t kill, prevent or stop spreading viruses. The only treatment for a cold is rest and time. While your child may not feel his or her best, it’s important to remember that within 10-14 days, symptoms will likely improve and there’s no need to take an antibiotic.

TRUE: You should NOT get antibiotics every time you're sick.

Antibiotics will only work for bacterial infections diagnosed by your health care provider. Examples include infections such as skin abscesses/impetigo, bacterial pneumonia, urinary tract infections, streptococcal pharyngitis, some middle ear infections and bloodstream infections. Certain antibiotics should be used very infrequently in children, such as azithromycin, commonly known as the “Z-Pak,” so it’s important to ask your child’s doctor what is truly necessary for their bacterial infection.

Lastly, it is important to understand that antibiotics can have adverse side effects. Another reason to avoid inappropriately taking antibiotics is due to allergic reactions. Among children ages 5 years and younger who presented to an emergency center for any adverse drug reaction, 80 percent were due to antibiotics. Antibiotics can also cause diarrhea (severe form related to a bacteria called Clostridioides difficile) and injury to the kidney, liver and bone marrow.

Always remember, antibiotics do not treat viruses, so never ask your doctor to prescribe you an antibiotic for a virus.

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