You’re exhausted. The kids are sick again. You’re sleep-deprived, the chores are piling up and you just want it to be all over!

This time round, your little one has had a runny nose like Niagara Falls and keeps waking up every 2 hours with a chesty cough, sounding as wet as a sponge.

What do you do?

Give it a couple more days to run its course? Or would antibiotics make everything better?

 * * *

Does this situation sound very familiar?

If so, you’re not alone.

Sick kids bringing home an endless wave of viral and bacterial infections from childcare and school is an all too familiar story for many mums and dads. Last week it was hand foot and mouth. This week it’s chesty coughs and runny noses. Next week it’s a gastroenteritis outbreak. Any other surprise gifts for mum this Winter?

Putting humour aside, many parents and caregivers often do sincerely ask the question, when does my sick kid need antibiotics?

The answer is quite interesting, if you’re willing to take a moment to understand the important difference between viruses and bacteria and how they’re treated.

Bacteria are microscopic organisms that have a cell wall. We all have billions of them living on our skin and in our bodies. Most bacteria are harmless and many play a critical role in the environment and even our bodies, for example, being essential to our gut microbiome. Other bacteria can cause diseases.

Antibiotics were discovered around a hundred years ago, and can cure disease by killing bacteria. Antibiotics work in many different ways, but one common way is to destroy the cell wall of bacteria. A very important point is, antibiotics do not kill viruses.

Viruses differ from bacteria in that they don’t have a cell wall and actually invade a body’s cell in order to start replicating and producing more viruses. This is one of the reasons why antibiotics won’t work against viruses.

Let’s take the example of an otherwise healthy child with cold and flu-like symptoms (runny nose, cough and sore throat), i.e., likely a viral infection. Most of these kids will usually be able to “run the course” of their illness with 7-10 days of rest and symptom treatment. In the majority of cases, your child’s immune system will be activated to fight off the viral infection by itself. It just takes time, and a lot of patience and persistence.

Some examples of symptom treatment for viral infections include paracetamol for fever and pain, cold and flu medicines, lozenges, steam inhalation and decongestants.

With enough time, most viral upper respiratory tract infections in otherwise healthy children, will get better by themselves.

You might be asking, can my child take an antibiotic “just in case”? The downside to this approach is a bacteria’s clever ability to develop resistance against an antibiotic if exposed to it unnecessarily (eg, for a common cold). Over time, what we would see in this scenario of antibiotic resistance is your child facing difficulty fighting off a true bacterial infection when it finally strikes.

Not to mention the wider problem of antibiotic resistance affecting the community, and world at large, including vulnerable elderly relatives. And lastly, we mustn’t forget the possible side effects antibiotics can create include diarrhoea, bloating, thrush and disrupting the important gut microbiome.

So, by now you might still be asking the question, so when does my child truly need antibiotics?

Every child, and every infection is different, so it’s always best to make an appointment with your GP if you’re not sure.

However, some general pointers for when antibiotics may be warranted can include a child with a prolonged fever and signs of severe Strep throat (pus on the throat with difficulties eating and maintaining hydration); a cough with crepitations on the lungs (a crackling noise heard via a stethoscope by your GP); or an eardrum with signs of pus behind the eardrum (observed by your GP using an otoscope).

To make matters even more complex, not all cases of tonsilitis, ear infections or wet-sounding, productive coughs need antibiotics! Many milder cases will resolve by themselves with just time and adequate pain-relief alone.

So, what’s the take home message from all of this?

The bottom line is, if your kids fall sick this winter, remember that most kids will develop simple viral infections that don’t need antibiotics. However, if you’re unsure, it’s always best to get it thoroughly checked!

If you’re looking for a medical practice to care for your family, our GP’s at Dural Family Medical Practice would be delighted to meet your family, do a thorough check-up and answer any further questions you may have!

Stay safe and well,

– The Doctors at Dural Family Medical Practice

Dural Family Medical Practice is a family-focused medical centre in Dural serving the local community in the Hills District for over 30 years. Our GP’s strive to provide comprehensive, holistic, compassionate medicine in a world of medical misinformation. Please check out our website www.dfmp.com.au to book an appointment online, or give our team a call on 9651 2077 today.

DISCLAIMER: If your child is unwell, this article is not designed to be used as medical advice to replace seeing your GP. If your child is unwell, please make an appointment to see a GP for a thorough assessment. This article is designed for educational purposes only.