Parents Often Wrong About When Kids Should Take Antibiotics

Coughs, runny noses, sore throats, and earaches are an inevitable part of life with young children. But a new survey suggests that some parents greatly overestimate how much prescribing antibiotics for kids will help.

Researchers at Bond University in Queensland, Australia, asked 400 parents with kids aged 12 and younger about when it was appropriate to use antibiotics for common upper respiratory illnesses. Results, published this week in the Annals of Family Medicine, reveal that most parents think antibiotics help to cure a cough (55 percent), sore throat (70 percent), and ear infection (92 percent).

These misconceptions about what antibiotics can cure are common among American parents as well. In a recent Harris poll of U.S. adults, more than half of respondents said that antibiotics are effective against viral infections. Forty percent thought that the drugs help cure a cold.

These beliefs about what antibiotics can remedy are not true, says Marvin Lipman, M.D., Consumer Reports’ chief medical advisor. “Most respiratory infections such as bronchitis, colds, ear infections, and sinus infections in both kids and adults are caused by viruses, not bacteria," says Lipman. "And antibiotics don’t work against viruses.”

Many respondents to the Australian survey also thought that antibiotics could help children recover faster or reduce the risk of complications.

This is also a myth, says Lipman. “The drugs won’t shorten the duration of a viral illness or reduce the risk that it will develop into something worse,” he says.

Why Doctors Prescribe Unnecessary Antibiotics

Almost 30 percent of the time, when doctors prescribe antibiotics for kids, the medications aren’t needed, according to the Centers for Disease Control and Prevention (CDC).

The Bond University researchers note that primary-care doctors may resort to antibiotics for several reasons. They may not be certain if an infection is caused by a virus or a bacteria, for example, and prescribe an antibiotic “just in case.” Or they may want to get through an appointment quickly and satisfy worried moms and dads.

Indeed, a survey of 155 U.S. emergency-department and primary-care doctors published in 2014 found that physicians’ concerns about patient satisfaction ratings influenced their practice. Almost half the physicians believed that the pressure to obtain better scores prompted inappropriate prescribing, including unnecessary prescriptions for antibiotics.

Lipman points out that it’s never a good idea to prescribe an antibiotic to a child when it’s not needed because the drugs commonly cause unpleasant side effects such as diarrhea, nausea, vomiting, and a rash. And more rarely, they cause more serious harm.

A recent study from the CDC revealed that side effects from antibiotics, most commonly severe allergic reactions, are responsible for more than 65,000 children being rushed to the ER every year. For children younger than 5, side effects from antibiotics such as amoxicillin (Amoxil, Moxatag, and generic) and azithromycin (Zithromax, Z-Pak, and generic) are the leading cause of ER visits due to adverse drug effects..

What’s more, overuse of these drugs is contributing to the rise of dangerous superbugs—strains of bacteria that are resistant to multiple antibiotics. The result is a growing number of infections that are more virulent and much harder to treat.

Below, recommendations from three medical specialty organizations regarding the use of antibiotics for ear and respiratory infections.

Children’s sore throat, cough, runny nose

American Academy of Pediatrics

Colds, coughs, bronchitis, and most cases of sore throat are caused by viruses and aren’t helped by antibiotics.

Consider antibiotics if: Your child has a sore throat and a strep test confirms that it’s caused by a bacteria. Colds and coughs typically clear up in a couple of weeks. If your child has a cough or congestion that lingers longer than that, see your doctor. The cause could be an underlying bacterial form of pneumonia or a sinus infection that is treatable with antibiotics.

Sinus infections (sinusitis)

American Academy of Allergy, Asthma & Immunology

Sinusitis is almost always caused by a virus. Symptoms include a stuffed-up feeling, a runny nose, pain in the face, and fever. Even when bacteria are causing the symptoms, these infections usually clear up on their own in about a week.

Consider antibiotics if: Your child has symptoms that suggest the sinus infection may be caused by a bacteria. One telltale sign is a high fever with and thick, colored mucus for three or more days in a row. A bacteria may also be the culprit if symptoms are milder but linger longer than 10 days. Or if congestion appears to be clearing up and then suddenly comes back with a fever or pressure and pain in the face.

Children’s ear infections

American Academy of Family Physicians

Most ear infections improve on their own in two or three days, especially in children age 2 or older. Give your child over-the-counter pain relievers for a few days, and avoid antibiotics. Take your child to a doctor if symptoms aren’t better in two to three days or they get worse at any time.

Consider antibiotics if: An infant is 6 months or younger. Babies can’t communicate how severe their pain is, and, at that age, serious infections have risks such as hearing loss. For children aged 6 months to 2 years, antibiotics are typically reserved for more serious infections—the child has a fever of 102° F or higher, for example, or has pain that isn’t relieved by OTC medications. For children older than 2, doctors are typically advised to take a watchful waiting approach unless a child has a high fever and severe pain. 

Those recommendations are part of the Choosing Wisely campaign, which details overused tests and treatments from more than 70 medical specialty organizations. Read more about the safe and effective use of antibiotics in Choosing Wisely recommendations produced in partnership with Consumer Reports.

Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

More from Consumer Reports:
Top pick tires for 2016
Best used cars for $25,000 and less
7 best mattresses for couples

Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2017 Consumer Reports, Inc.