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Column originally published Dec 29, 2015

Antibiotic Resistance

Question: Our three-year-old son was sick most of last winter. He got one cold after another, and was given several courses of antibiotics for sore throats and ear infections. I recently heard that it is not a good idea to take antibiotics unless if it is absolutely necessary. What can I do to keep him healthy this winter?


You are right, antibiotics should be used to treat significant bacterial infections only.  Most of the colds in winter are caused by viral infections; antibiotics will not make him recover faster.  Let me explain to you in more detail here.

The first antibiotic we have was penicillin.  It was first used during the Second World War, saving many lives.  However, within a few short years, some bacteria have already developed resistance to penicillin.

Over the next few decades, many different antibiotics were discovered and used around the world.  The newer antibiotics are stronger and able to overcome resistance that bacteria developed.  Most of us are not dying from infections any more.  For a while, it looked like medical science has finally conquered bacteria.

Unfortunately, in the past twenty years, bacteria have made a comeback.  They have developed new ways to survive and avoid being killed by these newer antibiotics.  Bacteria can multiply several times in an hour.  They can mutate and change their genes when they multiply.  Within a relatively short period of time, bacteria can become resistant to an antibiotic that they encounter.  Furthermore, bacteria can share their resistant genes with each other.

With widespread use of powerful antibiotics around the world, in animal feeds as well as in sick people, scientists have discovered many strains of bacteria that are resistant to virtually all antibiotics available to doctors.  In recent years, many thousands of people here and in other countries have contracted these multiple-resistant bacterial infections and died.

The World Health Organization (WHO) is leading a worldwide campaign to educate doctors, pharmacists, and the public, about the seriousness of antibiotic resistance.  Doctors have been told to prescribe antibiotics only when significant bacterial infection is present.

Most of the colds and sore throats in winter are caused by viruses.  Unless there is bacterial complications, antibiotics will not make the infection go away faster.  Fever and pain can be treated with acetaminophen and ibuprofen; you need to give an adequate dose according to your son’s weight, and not his age.  Check with your doctor or pharmacist to find out the proper dose for him.

Sore throats usually get better after a few days.  Make sure he gets plenty of fluids.  Having earache does not necessary mean that he has an ear infection.  In many countries, ear infections are not treated with antibiotics; most of them will get better after a few days.  A decongestant nose spray can reduce nasal congestion and open the small tubes that connect the back of the nose to the ears.  This can prevent ear infections and reduce the need for antibiotics.

Occasionally, virus infections can lead to more serious bacterial complications.  When that happens, antibiotics will become necessary.  If a cold doesn’t get better after several days, or if he gets much worse than you expect, you should consult your doctor.  Otherwise, don’t run to her with every cold and cough; your doctor may feel pressured to prescribe antibiotics to him.