Antibiotics are used to treat infections caused by bacteria. Many childhood infections are caused by viruses and would have got better without antibiotics. But the picture is complicated as some infections caused by viruses can lead to an infection by bacteria. This is known as a secondary bacterial infection.
Taking antibiotics unnecessarily can cause bacteria to change so that they can no longer be killed by antibiotics which were once effective – they become ‘antibiotic resistant’. Resistant infections are more difficult to treat, making people more unwell for longer.
Deciding who will benefit from antibiotics is not always easy. Children who have a long term medical condition or disability may need antibiotics more frequently to help them recover from bacterial infections, such as chest infections and ear infections.
Resistance vs ‘immunity’
The parents we spoke to were all aware that it isn’t a good idea to take antibiotics ‘too often’, saying that ‘obviously’ they preferred to avoid antibiotics. People had seen posters at their doctors, read articles in magazines and newspapers and heard from friends and family, as well as their doctors, that there was a danger from ‘overuse’.
However many thought that antibiotics should be avoided because the child might become ‘immune’ or ‘build up tolerance’ or ‘resistance’. As some of the parents knew, it is the bacteria, not the child that is in danger of becoming resistant; this is why reducing the use of antibiotics is so important.
Parents’ other concerns about using antibiotics included:
- Fears about what would happen when bacteria become resistant and we no longer have treatments
- A preference to fight infection naturally, with the body
- Concerns that the body may get overloaded with the various medicines the child takes for their long term health problems
- Antibiotics can cause digestive problems by destroying friendly microbes in the gut
- Worries that GPs (especially in the past) hand our antibiotics inappropriately, for example for viruses
- The necessity of completing the course of antibiotics once started, even if the problem has resolved
- Antibiotics are precious and should be reserved for when really needed, as the last resort
- Whether their child’s frequent use of antibiotics in their early years was storing up problems for their future health
Clare worries about moving into a post-antibiotic era if new drugs are not found.
Jack usually needs a stronger antibiotic to treat his infections. On one occasion when he was prescribed amoxicillin, his consultant said it was, as useful as a chocolate teapot.
Parents sometimes contrasted the apparently casual use of antibiotics when they were growing up with the current concerns about overuse. Knowing that, these days, doctors are reluctant to encourage use of antibiotics several parents said that if the doctor recommended use, they would certainly follow the advice.
Parents we interviewed who wrongly thought that there was a danger of the child becoming immune if they used too many antibiotics. Others could not understand why GPs didn’t want to use them with their child. As one said, ‘I know for a fact that my boys haven’t been on them long enough to build a tolerance to the. So I don’t see how. I could understand if you were in there every week saying ‘I want this, I want that’ .’
It is the bacteria, not the child that is in danger of becoming resistant (immune) to the antibiotic. This matters because it shows that doctors need to explain clearly the reasons why they are trying to reduce prescribing.
Doctors sometimes give a prescription but recommend waiting a few days before taking it, in the hope that the infection will clear up on its own. Ruth was given a prescription for antibiotics to take home and use if her daughter’s symptoms didn’t improve. Adam experienced the same at his GP and he agreed with this approach to managing antibiotic use for his son.
Although parents had concerns about their children taking too many antibiotics they also accepted that sometimes they needed antibiotics to prevent them becoming seriously ill.
Parents thought carefully before asking their GP for antibiotics. In some cases, they waited to be sure that the infection was not getting better before giving antibiotics to their child. Sharon tries to limit the need for antibiotics by increasing Henry’s asthma inhaler as soon as a cold begins and so hopefully preventing the infection from progressing.
Taking antibiotics to prevent infections
Some children took a low dose of antibiotics every day to prevent infections. It is understandable, given the concerns expressed above, that parents of these children were initially worried about their child being on antibiotics long term. After being reassured by her son’s consultant Michelle felt more confident about Jack using them for prevention; she thought that the antibiotics had ‘kept him nice and steady.’