Why doctors should not prescribe (and parents not request) antibiotics unless absolutely necessary

Every treatment has potential benefits and potential harms. Doctors have to weigh these two things against each other whenever they are making a decision to treat an infection or other illness. Side effects of antibiotics in individual children can range from mild (mild rash, mild diarrhea) to severe (allergic reaction, severe diarrhea including C. difficile colitis, deadly heart rhythms). When you take antibiotics for a viral infection you receive no benefit and only have the potential for harm.

In addition to the side effects that can occur in an individual who takes an antibiotic, there are effects of antibiotic use on the millions of bacteria that live in our bodies in our digestive and respiratory tracts and on our skin (the microbiome). We know that exposure to antibiotics increases the risk of antibiotic resistant bacteria in the individual and the community and can lead to infections that are difficult to treat. For this reason, antibiotics are the only medicines that can affect other people when you use them. These medicines are a precious resource and if we misuse them, we will not have them to use in the future because bacteria will have figured out how to avoid being killed by them. This has already happened in some types of infections that affect very ill, hospitalized people.

New research is revealing that the effect of antibiotics on the normal bacteria in our bodies can have long-term effects outside of their effects on antibiotic resistance. There are some chronic diseases for which changes in our healthy bacteria (microbiome) can possibly increase the risk of diseases such as asthma, eczema, inflammatory bowel disease and even obesity.

Le Bonheur has an “Antimicrobial Stewardship Program” run by infectious disease specialists and pharmacists. This group has been working for several years to reduce the unnecessary use of antibiotics in the hospital through a variety of interventions. In the future, they are planning to expand this program to the Le Bonheur community to educate physicians and patients on the most appropriate ways to use antibiotics for infections seen in the clinic setting. You can help in this effort by not asking for antibiotics when your doctor thinks they are unnecessary. This is vital for the health of our community and our ability to continue to fight infections with antibiotics in the future.