Antibiotic drugs should be used only for infections caused by bacteria. In hospital with severe and life-threatening infectious diseases (for example, meningitis – inflammation of brain membranes, pneumonia – lungs inflammation, etc.), responsibility for correct choice of medicine lies entirely with a doctor, which is based on patient’s examination (clinical picture) and results of special research.
With mild infection occurring in outpatient conditions, the situation is fundamentally different. The doctor examines the child and prescribes medicines, and sometimes it is accompanied by explanations and answers to questions, sometimes – no. Often parents themselves ask the doctor to prescribe an antibiotic. In such situations, it is sometimes psychologically easier for a pediatrician to prescribe a prescription than to put his reputation at risk and spend time explaining inexpediency of such appointment.
In any case, a doctor must follow two basic principles of antibiotic therapy:
- quick appointment of the most effective drugs in cases when their effect is proven.
- the maximum reduction in the use of antibacterial drugs in all other cases.
Reliable external signs or simple and cheap laboratory methods that make it possible to distinguish viral and bacterial nature of respiratory tract infections, unfortunately, do not exist. At the same time, it is known that acute rhinitis and acute bronchitis (inflammation of bronchial mucosa) are almost always caused by viruses, and angina (inflammation of palatine tonsils and pharynx), acute otitis (ear inflammation) and sinusitis (inflammation of the mucous membrane of the paranasal sinuses ) in large number of cases – by bacteria.
It is natural to assume that approaches to antibacterial therapy of certain acute infections of upper respiratory tract should be somewhat different.
A Runny Nose and Bronchitis
In acute rhinitis (a runny nose) and bronchitis, antibacterial drugs are not indicated. In practice, everything happens in a different way: one or two days of high fever and cough in a child, parents usually do not give baby antibacterial drugs. But then they begin to fear that bronchitis will be complicated by pneumonia, and they decide to use antibiotics from a Canadian pharmacy.
Here it is worth noting that such a complication is possible, but it is almost independent of antimicrobial preparations that were used before. The main signs of pneumonia development are deterioration of condition (the further increase in body temperature, increased cough, dyspnea appearance). In such a situation, you should immediately call a doctor who decides whether to correct treatment.
If the condition does not worsen but does not improve significantly, then there is no obvious reason for prescribing antibacterial drugs. Nevertheless, it is during this period that some parents do not stand up and start giving drugs to children “just in case”.
Especially it should be noted that very popular criterion for prescribing antibacterial drugs for viral infections – high temperature for 3 days – is absolutely unjustified. The natural duration of the febrile period for respiratory tract viral infections in children varies considerably, fluctuations from 3 to 7 days, and sometimes more, are possible. Longer maintenance of the so-called subfebrile temperature (37.0-37.5 0C) is not necessarily associated with bacterial complications development but may be the result of completely different causes. In such situations, the use of Canadian antibiotics over the counter is doomed to failure.
A typical sign of viral infection is a persistent cough on the background of improvement in general condition and body temperature normalization. It must be remembered that antibacterial drugs are not antitussive agents. Parents in this situation have ample opportunities for traditional antitussives use. A cough is a natural defense mechanism and disappears the last of all disease symptoms. However, if the child has an intense cough lasting 3-4 weeks or more, one must search for its cause.
Pneumonia and Antibiotics
With pneumonia, the tactics of an antibiotic therapy differ from two previously described cases.
For certain age groups of children, some features of prevailing pathogens are characteristic. So, at the age of 5-6 years, according to some researchers, up to 50% of cases of pneumonia can be caused by viruses. At an older age, the probability of viral nature of pneumonia is significantly reduced and the role of bacteria (pneumococci) in pneumonia development increases. However, in all age groups, frequent causative agent of this disease is pneumococcus, which causes severe disease course. That is why pneumonia is an indisputable indication for an antibiotic therapy appointment.