Does Your Child Really Need that Antibiotic?

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Experts advise parents to be aware of when antibiotics are necessary for their children and when they aren’t. Marko Geber/Getty Images
  • Researchers say a high percentage of children are prescribed antibiotics that they don’t need.
  • This trend could lead to an increase in health-related costs because children may not receive the appropriate treatment in certain cases.
  • Experts advise parents to educate themselves on when antibiotics are appropriate and when they aren’t.

Is your child’s pediatrician prescribing unnecessary antibiotics and would you know if they did?

According to an investigation published in JAMA Network Open, some $74 million in “inappropriately prescribed” antibiotics were given to children in the United States outside a hospital setting in 2017.

Inappropriate prescriptions were defined as those that are non–guideline-recommended.

Researchers analyzed data from 2.8 Million children between April 1, 2016 and September 30, 2018, for the investigation.

They found that 36% to 36% of these children received incorrect antibiotics for bacterial infection, and 4 to 70% for viral infection. ​​

According to investigators, inappropriately giving antibiotics to children can have serious consequences for the family and the healthcare system.

Both increased medical costs and risks of adverse drug reactions were noted.

They also reported that there was an increase in healthcare costs after 30 days for those who received antibiotics. Researchers found that the healthcare costs per child ranged from $21-$56 for bacterial infections to $96 for viral ones.

The highest national annual attributable expenditure estimates for chronic middle ear infections ($25 million), pharyngitis (21 million), and viral higher respiratory infection ($19million) were the highest.

“These findings highlight the individual and national-level consequences of inappropriate antibiotic prescribing and further support implementation of outpatient antibiotic stewardship programs,” the researchers wrote.

Dr. Preeti Jaggi, the director of antimicrobial stewardship at Children’s Healthcare of Atlanta and an associate professor of pediatrics at Emory University, said these findings provide another example in a growing body of evidence of the adverse effects of unnecessary prescribing of antibiotics.

“We have seen similar studies showing the same type of problems in hospitalized patients and this study focused on those not hospitalized. In addition to the adverse events that kids experienced, there was also a considerable monetary cost,” Jaggi told Healthline.

Dr. Daniel Ganjian, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California, said the findings ultimately support the goal of the American Academy of Pediatrics(AAP) to reduce inappropriate antibiotic use

“It is so easy to give antibiotics to a desperate parent who wants her child to feel better, but a good pediatrician will take the time to explain the difference between a viral and bacterial infection, and will try his/her hardest to not prescribe antibiotics,” Ganjian told Healthline.

Experts say that even though the data was from 2016-2018, the concern over antibiotic misuse in children is still pertinent.

Ganjian said parents need to know that pushing their child’s doctor to prescribe antibiotics puts a strain on the healthcare system, which is one of the reasons for the rising costs of health insurance.

These experts offer the following advice to parents:

Do not ask for antibiotics

Do not go into the doctor’s office asking for antibiotics.

“My advice to parents of non-hospitalized children is to let your clinician make an assessment without any pressure from you about the need for antibiotics,” Preeti said.

“Clinicians should prescribe antibiotics for a specific clinical diagnosis that is caused by a bacteria, not ‘just in case’ when a diagnosis is unclear,” she added.

Look for a pediatrician that follows the AAP guidelines, such as Ganjian.

Know when antibiotics may be required

Knowing when antibiotic use in children is appropriate (and when it’s not) is also important.

“If your child has a cough and runny nose for less than 2 weeks and fever less than 5 days, then your child will most likely not need antibiotics,” said Ganjian.

“But still have your pediatrician listen to your child’s lungs to make sure there is no lung infection or pneumonia,” he added.

If you have concerns about inappropriate use of antibiotics, Ganjian says the best line to say is, “Doctor, I would rather not use antibiotics, but I would like to know what your opinion is after you have finished examining my child.”

Ask questions and be curious

“I think it is always reasonable to ask your clinician about the risks and benefits of receiving antibiotics if they are prescribed,” Ganjian said. “If your child’s illness has been prolonged, such as a prolonged duration of fever, you should call your clinician back to re-assess if the clinical diagnosis has changed.”

Finally, don’t be afraid to get a second opinion if you think your pediatrician is inappropriately prescribing antibiotics, experts say.

“If your child gets a prescription of antibiotics whenever he/she is sick, consider getting a second opinion, unless your child has a chronic medical condition or has an immune deficiency [which may change the script for when it’s appropriate to use antibiotics],” Ganjian said.

Source: Health Line

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