Saturday 20 April 2019

Dear Dr Nina: 'I'm worried about stopping my child's antibiotic treatment after just one dose'

It is usually recommended to complete an entire course of antibiotics
It is usually recommended to complete an entire course of antibiotics

Question: My one-year-old son was given an antibiotic by a locum doctor and I gave him one 5ml dose. I then stopped as I felt he didn't need it and he indeed recovered on his own. Will this one dose have done any harm to his gut bacteria? Or any other harm by not finishing the dose?

A Antibiotics are a group of medicines that kill bacteria. When used correctly they can be lifesaving because when the right antibiotic hits a certain bug it works quickly to kill it. However, most coughs, colds and sore throats occur due to viruses and antibiotics will not help in this case.

There is a serious overuse of antibiotics worldwide. In Ireland, we prescribe approximately 24 antibiotic doses per 1,000 population per day. Our antibiotic use is amongst the highest in Europe. As we use more and more antibiotics, bacteria are becoming clever and developing ways to become resistant to what have been lifesaving drugs. The pharmaceutical industry is finding it hard to produce newer, more effective antibiotics and the real danger in the future is that as more and more super bugs emerge we could see people once again dying from what should be treatable illness.

You are absolutely right to be cautious about antibiotic use.

There are a number of misguided ideas about antibiotics. They will not shorten a viral illness. They don't help reduce fever or pain or make you feel better. They will not prevent the transfer of viral illness to other people. Antibiotics are not universally safe. Side effects from the use of these can be a common cause of attendance to A&E departments. Severe allergic reaction to antibiotics can be life-threatening.

Diarrhoea from antibiotics can cause dehydration and destroy healthy gut bacteria, which aid with digestion and well-being. Taking probiotics while being treated with antibiotics may reduce the chance of related diarrhoea and gastro-intestinal upset. Antibiotics can interact with other medication, making them less effective. It is very important to only take antibiotics that have been prescribed for a specific illness for you by your doctor.

It sounds like you child had a virus as they recovered well without the need for antibiotic treatment. A single dose of antibiotic wouldn't have treated a bacterial infection fully. Rest assured that a single dose wont have done any major harm and would be unlikely to cause resistance in the future. However, if you have been prescribed an antibiotic, it is usually recommended that you take it as directed and complete the entire course even if you feel better after a few days. A full treatment course is between three and 14 days, with seven being the average required for most respiratory infections. Partially treating an infection may give the bacteria just enough exposure to the antibiotic to become resistant, whereas completing the course is likely to kill it completely.

The right drug at the right time for the right disease is the best treatment plan.

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