Antibiotics for Children: 10 Common Questions Answered

Antibiotics for Children: 10 Common Questions Answered

Using antibiotics when they are not the right medicine will not help. In fact, it may even cause more harm than good. Why? Because antibiotics only treat infections caused by bacteria—not viruses. Plus, like all medications, antibiotics have side effects.

Before prescribing an antibiotic, your pediatrician will find out if it is the right medicine to treat your child’s infection.

In this article, we answer common questions about the use of antibiotics. Talk with your child’s doctor if you have other questions and see 10 Common Childhood Illnesses and Their Treatments for more information.

  1. My child has a really bad cold. Why won’t the doctor prescribe an antibiotic?

    Colds are almost always caused by viruses. Antibiotics only treat bacteria. In general, most common cold symptoms—such as runny nose, cough, and congestion—will get better without using any medicines.
    Many young children—especially those in child care—can get 6 to 8 colds per year.
  2. Don’t some colds turn into bacterial infections? So why wait to start an antibiotic?

    In most cases, bacterial infections do not follow viral infections. Treating viral infections with antibiotics almost never prevents bacterial infections; however, they may instead cause diarrhea or other side effects.
  3. Isn’t a nose draining yellow or green mucus a sign of a bacterial infection?

    Yellow or green mucus in the nose does not automatically mean that antibiotics are needed. During a common cold, it is normal for mucus from the nose to get thick and to change from clear to yellow or green. This is most often from viral infection, which can last for up to 10 days. Sinusitis is a term that means inflammation of the lining of the nose and sinuses. A virus or allergy can cause sinusitis and, in some cases, bacteria can be the cause. Your child may have bacterial sinusitis if they have these signs:

    – cold symptoms that last longer than 10 days and are not improving
    – thick yellow or green mucus with a fever higher than 102 F (39 C) for at least 3 or 4 days
    – facial pain with fever

    In these uncommon situations, an antibiotic may be needed. See The Difference Between Sinusitis and a Cold.
  4. Aren’t antibiotics supposed to treat ear infections?

    At least half of all ear infections go away without antibiotics. Many true ear infections are caused by viruses and do not require antibiotics. Even some of the ear infections that are caused by bacteria will go away on their own without antibiotics. If your pediatrician believes your child’s ear infection does not need antibiotics, they will talk with you about comfort care. They can recommend the best ways to help relieve your child’s ear pain until the infection runs its course.

    Because pain is often the first and most uncomfortable symptom of ear infection, your child’s doctor will suggest pain medicine to ease your child’s pain. Acetaminophen and ibuprofen are over-the-counter pain medicines that may help lessen the pain. Be sure to use the right dose for your child’s age and size. In most cases, pain and fever will improve within the first 1 to 2 days.

    Over-the-counter cold medicines (decongestants and antihistamines) don’t help clear up ear infections and are not recommended for young children. Ear drops may help ear pain for a short time, but always ask your child’s doctor if your child should use these drops.

    Your child’s doctor may prescribe antibiotics if your child has a higher fever, more severe ear pain or infection in both eardrums. See Ear Infection InformationMiddle Ear Infections, and Your Child and Ear Infections.
  5. Aren’t antibiotics used to treat all sore throats?

    No. Most sore throats are caused by viruses. If your child has sore throat, runny nose, and a cough, a virus is likely the cause. In these cases, a test for “strep” should not be given.

    Antibiotics should only be used to treat sore throats caused by group A streptococci. Infection caused by this type of bacteria is called “strep throat“.

    Children under 3 years old rarely get strep throat.

    If your child’s doctor suspects strep throat based on your child’s symptoms, a strep test should always be performed. If the test is positive, antibiotics will usually be prescribed. See The Difference between a Sore Throat, Strep & Tonsillitis and When a Sore Throat is a More Serious Infection.
  6. Do antibiotics cause side effects?

    Side effects occur in up to 1 in 5 children who take an antibiotic. Side effects may include rashes, allergic reactions, nausea, diarrhea, and stomach pain. Make sure you let your child’s doctor know if your child has had a reaction to antibiotics in the past.

    Sometimes a rash will occur during the time a child is taking an antibiotic. However, not all rashes are considered allergic reactions. Tell your child’s doctor if you see a rash that looks like hives (red welts) soon after taking the first dose of an antibiotic; this may be an allergic reaction.
  7. How long does it take an antibiotic to work?

    Most bacterial infections improve within 48 to 72 hours of starting an antibiotic. If your child’s symptoms get worse or do not improve within 72 hours, call your child’s doctor.
  8. Can antibiotics lead to resistant bacteria?

    The repeated use and misuse of antibiotics can lead to resistant bacteria. Resistant bacteria are bacteria that are no longer killed by the antibiotics commonly used to treat them. These resistant bacteria can also be spread to other children and adults.

    It is important that your child use the antibiotic that is most specific for your child’s infection, rather than an antibiotic that would treat a broader range of infections.

    If your child develops an antibiotic-resistant infection, a special type of antibiotic may be needed. Sometimes, these medicines need to be given by IV (vein) in the hospital.
  9. What are antiviral medicines?

    An antiviral medicine may be prescribed for children that are at higher risk of becoming severely ill if they get the flu. For most other viruses causing cough and cold symptoms, there are no antiviral medicines that work.
  10. How can I use antibiotics safely?

    Give the medicine exactly as directed. See Medication Safety Tips and Using Liquid Medicines.
    Don’t use one child’s antibiotics for a sibling or friend; you may give the wrong medicine and cause harm.
    Keep antibiotics and other prescription medicine in a secure place. Count and monitor the number of pills you have and lock them up. Ask your friends, family members, and babysitters to do the same.
    Dispose leftover antibiotics and other prescription medication. Return leftover prescriptions to a hospital, doctor’s office, or pharmacy. Many counties now offer “take-back” events to collect unused medication. For more information see Promote Safe Storage and Disposal of Opioids and All Medications.

Have more questions?

If you have any questions or concerns about appropriate care for your child, please discuss them with your pediatrician. While it may be tempting to go to a nearby after-hours clinic if your child is ill, your pediatrician knows your child best, has your child’s medical records, and is the best place to start for advice. Ask your pediatrician how they would like to be contacted when the office is closed.

The AAP does not recommend retail-based clinics, telehealth services outside of the medical home, or acute care services without pediatric expertise for children younger than 2 years. See Urgent Care: Is It Worth the No Wait? for more information.