Too many antibiotics spoil the child?

Parents are often reassured when a trip to the pediatrician results in an antibiotic prescription for their sick child. But doctors too often write such prescriptions when it s just not necessary, reports a large study just published in Pediatrics.

The study, which looked at a nationally representative sample of nearly 65,000 outpatient visits by children from 2006 to 2008, puts the number of unnecessary antibiotic prescriptions at 10 million per year. The concern, says study author Dr. Adam Hersh of the University of Utah in Salt Lake City, is that an unneeded course of antibiotics might result in later infections with antibiotic-resistant bacteria in the child, and an increase in antibiotic-resistant infections in the population overall. His study found that almost one quarter of all antibiotic prescriptions are doled out to children with respiratory conditions such as bronchitis, the flu, asthma, and allergies which, in most cases, don't actually require an antibiotic.

Still, ACSH s Dr. Josh Bloom doesn t think it s fair to castigate pediatricians for every unnecessary antibiotic prescription. At the time when a doctor sees a child, it s not necessarily evident whether an infection is bacterial or viral and viral infections can, in some cases, actually lead to secondary bacterial infections. So antibiotic use may have been a reasonable response at the time. As he points out, Hindsight is always 20/20. Sometimes even better.

ACSH's Dr. Gilbert Ross agrees with Dr. Hersh that a good way to avoid over-prescription is simply to wait for several days before deciding on antibiotics. That amount of time can often make it easier to determine whether an antibiotic is called for. It takes time to explain to a concerned parent why you re not prescribing an antibiotic, Dr. Ross observes. Too often, a busy doctor will just find it easier to write out a prescription.