Antibiotics for Children: Frequently Asked Questions

Antibiotics are an essential tool in modern medicine, used to treat a wide range of bacterial infections in children. However, it’s important to use antibiotics responsibly, as overuse can lead to the development of antibiotic resistance, and antibiotics only treat infections caused by bacteria, not viruses. Plus, like all medications, antibiotics have side effects. So before prescribing an antibiotic, your doctor will find out if it is the right medicine to treat your child’s infection. In this blog post, Dr Shivani Paliwal from our Children’s Clinic will discuss the commonly asked questions from parents regarding antibiotic use in children. 


My child has a nasty cold. Why won’t the doctor prescribe antibiotics?

Viruses almost always cause colds. Antibiotics only treat bacteria. Most common cold symptoms, such as runny nose, cough, and congestion, will improve without medications.

Young children, especially children in childcare, can get 6 to 8 colds yearly. 


I’m concerned that my child’s cold will turn into a bacterial infection. Why should we wait to start an antibiotic?

In many cases, bacterial infections do not follow viral infections. Treating viral infections with antibiotics rarely prevents bacterial infections; however, they may instead cause other side effects like vomiting and loose stools.


Is a runny nose with yellow or green mucus a sign of a bacterial infection?

Yellow or green mucus in the nose is not a good indication to commence antibiotics. During a common cold, it is normal for mucus from the nose to get thick and to change from clear to yellow or green. The colour does not indicate an infection; in most cases, this is a viral infection lasting up to 10 days. 


Sinusitis which is the inflammation of the lining of the nose and sinuses, can be explored if your child displays signs of the following: 

  • Cold symptoms that last longer than 10-14 days without improvement
  • Thick yellow or green mucus with a fever higher than 39C (102F) for at least 3 to 4 days 
  • Facial pain with fever 

A virus or allergy can cause sinusitis; in some cases, bacteria can be the cause. 


My child has an ear infection, are antibiotics required?

Many ear infections will go away without antibiotics as they’re 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. However, comfort care is essential to reducing your child’s ear pain until the infection run’s its course. Ear pain is often the first and most uncomfortable symptom of an ear infection. Pain relief, such as Paracetamol and Ibuprofen, are over-the-counter pain medicines that may help ease the pain and inflammation. Be sure to use the correct dose for your child’s age and weight. In most cases, pain and fever will improve within the first 1 to 2 days. Over-the-counter cold medications are not recommended for young children and will not treat ear infections. 


Non-medicated ear drops may help with certain causes of ear pain, 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.


My child has a sore throat, are antibiotics required?

Viruses cause most sore throats. So if your child has a sore throat, runny nose and cough, a virus is a likely cause. A “strep” test would not be advised in this case. Antibiotics should only be used to treat sore throats caused by bacteria known as Group A Streptococci, commonly known as Strep Throat. Children under three years old rarely get strep throat. However, a strep test should always be performed if your child’s doctor suspects strep throat based on your child’s symptoms. If the test is positive, antibiotics will usually be prescribed. 


Do antibiotics cause side effects?

Side effects occur in up to 1 in 5 children who take an antibiotic. Side effects may include rashes, 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 when a child takes 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.


How long does it take an antibiotic to work?

Most bacterial infections improve within 48 to 72 hours of starting an antibiotic. However, if your child’s symptoms worsen or do not improve within 72 hours, call your child’s doctor.


Can antibiotics lead to resistant bacteria?

The repeated use and misuse of antibiotics can lead to resistant bacteria. Resistant bacteria are no longer killed by the antibiotics commonly used to treat them. These resistant bacteria can also be spread to other children and adults. Therefore, using antibiotics that are more specific to your child’s infection is essential, rather than a broad-spectrum antibiotic used to treat a broader range of infections. 


If your child develops an antibiotic-resistant infection, a special type of antibiotic may be given. Sometimes, these medicines must be administered by IV (vein) in the hospital.


What are antiviral medicines?

Antiviral medications are used to treat viral infections. They work by interfering with specific steps in the replication of viruses, which helps reduce the infection’s severity and duration. Unlike antibiotics, which are used to treat bacterial infections, antiviral medications are not effective against bacteria. Therefore, no antiviral medications will work for most other viruses causing cough and cold symptoms.


How can I use antibiotics safely?

  • Give the medicine as directed by your doctor. 
  • Stop the medication immediately if there are any signs of allergic reaction. Refer to A&E if you suspect anaphylaxis. 
  • Don’t use one child’s antibiotic for a sibling or friend; you may give the wrong medication 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 of leftover antibiotics and other prescription medication.
  • Monitor for any side effects and report to your doctor


If you have any questions or concerns about appropriate care for your child, please discuss them with your child’s doctor. 

Dr Shivani Paliwal is Board Certified Paediatrician from the USA. Dr Shivani Paliwal is Head of Department for IMC Children Clinic.

Dr Shivani Paliwal is a US Paediatric trained Doctor based at IMC Children’s. For appointments book online or call  65 3163 4341

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