Why won’t we prescribe antibiotics over the telephone?
Antibiotics are wonderful. However, ONLY when used for bacterial infections. Antibiotics are useless against viral infections.
So, how do you know if your child has a bacterial or viral infection? You feel we are very good healthcare providers, but we can promise you this… no provider can diagnose a virus versus a bacterial illness over the phone.
Unfortunately, in the real world of parenting, children sometimes complain of a sore throat over the weekend or wake crying with an earache at 1 am. Surely, it could not hurt to start an antibiotic just this once? What if you promise to bring your child into the office for that strep test Monday morning? Why do we have to be so difficult… all your friends’ doctors do it?
Well, let’s take a breath and look at this for a moment. If you feel we are “being difficult,” we are following guidelines set up by the American Academy of Pediatrics (AAP), a non-profit group of certified pediatricians and specialists dedicated to the health, safety and well-being of infants, children and adolescents.
Because of antibiotic misuse and overuse, antibiotic resistance has developed over time, and antibiotics have lost their effectiveness in battling some bacteria. Do you know that each time you take an antibiotic, sensitive bacteria are killed, but resistant germs are left to grow and multiply? According to the Center for Diseases Control and Prevention (CDC), repeated and improper use of antibiotics is the main cause for increase in drug-resistant bacteria. Declining your request for an antibiotic may not be the answer you are looking for but rest assured – we have your child’s best interests at heart.
This would include calling looking for antibiotic eye drops, antibiotics for UTI’s (that must be cultured to ensure the strain of bacteria is being treated with the most effective antibiotic), or any other ailment that may be just viral.
Here are some guidelines for common ailments:
Cold and cough: Colds and coughs typically last 10-14 days, and nasal drainage may even change from clear to thick or discolored -- not to worry, all is still well. If symptoms last beyond 14 days, see your doctor.
Sinus infection: Nasal congestion -- mucous may turn thick, yellow or green toward the end of a cold, this can be considered normal. However, if symptoms last beyond 10-14 days, facial pain and swelling or fever develops -- it is time for a doctor’s visit.
Sore throat: Many sore throats are viral, but we want to watch for strep infections which are bacterial. Of one thing, I am sure; strep throat can NEVER be diagnosed by looking in the mouth. A throat culture is necessary for a positive identification.
Bronchitis or non-specific cough: Coughs are usually part of a cold/viral infection; they serve to help clear the lungs of mucous and debris. If a cough lasts longer than 2-3weeks, see your doctor.
Ear infections: All ear infections are not created equally and are classified by doctors differently. Otitis Media with Effusion (OME), fluid in the middle ear, is commonly found in young children with colds -- about half. OME does not require antibiotic treatment. Though fluid is usually present in the middle ear with Acute Otitis Media (AOM) as well, it differs in that additional, specific signs of infection are present -- redness of the eardrum, fever, pus present behind the eardrum, drainage from the ear. Runny noses, ear pulling, changes in feeding or sleep patterns may raise a parent’s suspicions but does not diagnose an ear infection.
Below are links and information that will be helpful.
Courtesy of Johnson & Johnson/McNeil Healthcare Division
Courtesy of Bayer USA