How To Protect Your Kids from The 'Antibiotic Apocalypse'

Amid headlines about untreatable “nightmare bacteria,” experts warn that overuse of antibiotics, particularly for kids, has created a looming “antibiotic apocalypse.” New medical guidelines and a public health campaign by the CDC highlight the extreme importance of avoiding needless use of these drugs, which often do more harm than good.

It’s been common for parents to demand antibiotics for every sniffle and ear infection—and for doctors to write a prescription without thinking twice about the potential dangers of misusing the medications. In fact, the average American child receives 10 to 20 courses of antibiotics by age 18.

What’s the right way to protect kids’ health—and how can parents tell if antibiotics are actually needed? Here’s a look at what you need to know.

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The Lure of a “Quick Fix” for Childhood Illnesses

In an intriguing article in the Atlantic, infectious disease specialist Tim Lahey and his wife, Jessica, discuss how shocked their friends are to learn that their 14-year-old son has never taken antibiotics.

As the Laheys write, “Our friends are smart, highly educated people who know that antibiotics kill bacteria, not viruses. They know that most colds are caused by viruses. But they are also dedicated parents who would do anything for their kids, and when a child is sick, clear reasoning can get clouded by fear, desperation, and the lure of a quick fix.”

The article also captures the mindset that leads to antibiotic misuse for viral conditions like a cold or bronchitis. “After a week or two of yuck and snot [parents have] had it -- so they call the pediatrician for an antibiotic. The harried doctor knows it's likely viral but doesn't want to fight with yet another parent about antibiotics -- so out comes a prescription.”

Antibiotic Dangers

Among the hazards of improperly prescribed antibiotics are these:

• Increased risk for a potentially life-threatening antibiotic-related infection called C. difficile. Rates of this superbug, which kills 14,000 Americans a year, have recently hit an all-time high, according to the CDC. Deaths from C. difficile, which causes severe diarrhea that can lead to a sometimes fatal problem called toxic mega-colon, have soared by 400 percent since 2000.

• Drug side effects. As I recently reported, it’s been estimated that over 140,000 emergency visits are made to the hospital each year due to antibiotic-associated side effects, with allergic reactions being the most common. “Minimizing unnecessary antibiotic use by even a small percentage could significantly reduce the immediate and direct risks of drug-related adverse events in individual patients,” a 2007 study showed.

• Childhood obesity. Farmers have long used antibiotics to fatten up livestock—and there are decades of research showing similar effects in people—a significant concern given the childhood obesity epidemic. More than a half century ago, a randomized study published in Nutrition reported that young Navy recruits who were given daily doses of broad-spectrum antibiotics, such as chlortetracycline or penicillin, to prevent strep infections gained 4.8 pounds over 7 weeks, compared to a 2.7 pound gain in recruits given a placebo. 

• Eradicating beneficial gut bacteria. In the early 20^th century, helicobacter pylori was the dominant stomach microbe, Dr. Martin Blaser, a microbiologist professor at New York University Langone Medical Center, recently reported in Nature. Today, fewer than 6 percent of US kids carry the organism. While that may not sound like a problem, given that H. pylori raises risk for stomach ulcers and gastric cancer, Dr. Blaser has discovered that killing off this bug dramatically changes how the stomach works, tricking the body into overeating. 

An Epidemic of Drug-Resistant Superbugs

As the Atlantic reports, “Every year, more and more children with viral illnesses are given unnecessary antibiotics, and as a result, the bacteria floating around in our bodies get exposed to those antibiotics and evolve, gaining resistance to even our most powerful antibiotics.”

And the superbugs keep getting scarier. Not only are there recent reports of worldwide spread of completely drug resistant infections from E. coli and related bacteria striking hospital and nursing home patients, but there are now cases of nearly untreatable STDs, including drug resistant gonorrhea in the United States.

“Fast forward a few years and many fear there will be no life preservers left to toss to our kids, at which point we could be back where we were 100 years ago, watching people die from what are currently nuisance illnesses easily cured with a pill,” the Laheys write.

What Every Parent Should Know About Antibiotics and Superbugs

Smart Steps to Protect Against the Antibiotic Apocalypse

As scientists scramble to find new antibiotics—a type of drug research that gets relatively little funding—it’s crucial to avoid misusing the ones that we already have. Here’s what parents should know to help ward of the antibiotic apocalypse—the era when there are no effective treatments for killer diseases.

• Antibiotics are not necessary for colds and bronchitis.
• Contrary to what many parents think, green sinus discharge or sputum isn’t necessarily a sign that antibiotics are indicated. In fact, studies show that that green sputum is as likely to be viral as bacterial.
• New guidelines for kids’ ear infections from the American Academy of Pediatrics advise “watchful waiting” instead of an immediate antibiotic prescription.
• Evidence-based medical guidelines for sinus infections (which can be caused by bacteria or viruses) suggest that doctors check patients for certain red-flag symptoms that could signal a bacterial infection before writing a prescription. These include sudden severe symptoms, such as fever of 102 or above) and facial pain lasting at least 3 or 4 days; symptoms that persist for ten or more days without any improvement, or new or worsening symptoms.
• To tell if a child has pneumonia, which can be a legitimate use of antibiotics, doctors need to do a chest x-ray. Otherwise, this condition can be confused with bronchitis, which doesn’t require these drugs.
• If the pediatrician wants to prescribe antibiotics for any childhood ailment, always ask why and if there is any other treatment—including watchful waiting.
• If antibiotics are legitimately prescribed, always make sure your child takes the full course of medication, even if the symptoms clear up. Incomplete treatment may lead to tomorrow’s superbugs.

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