Autumn season, kids are prone to colds season. Many parents see a child with a fever, running nose, immediately give amoxicillin, or even higher levels of antibiotic to use it. But, really you need it? Antibiotics really work? Side effects of antibiotics you know?
The abuse of antibiotics has become a major problem around the world, in recent years, the boom in drug-resistant people worried. To curb the upper respiratory tract infection (commonly known as the common cold) when antibiotics abuse, US Centers for Disease Control CDC and the American Academy of Pediatrics AAP today (November 19, 2013) jointly issued a new flu antibiotic use guidelines , calling the majority of pediatricians less caution with antibiotics, the case of non-essential use is not the only use.
US statistics AAP said that every five pediatric clinic had a doctor will prescribe antibiotics, resulting in the United States each year about 5 ten million antibiotic prescriptions. Taking into account China can easily buy antibiotics, this situation is estimated to be much more serious too. 1 United States each year about ten million antibiotic prescriptions for respiratory diseases, and that most of them are useless. The abuse of antibiotics lead to unwanted side effects, promote the generation of resistant bacteria, but also increase the burden on health care. If we do not curb this trend, a large number of antibiotic resistant bacteria breeding will eventually lead to useless, time to face the terrible terror era of no cure.
Specifically, how to determine whether it is necessary to use antibiotics? Because this guide is written for doctors, ordinary parents would be more difficult to read. I simply translate. Pediatricians or parents to give you a reference.
Antibiotic use summed up three principles:
1. First determine whether the bacterial infection. Because most cases are viral infections, and viral infections with antibiotics, there are 100 victims without a profit. It is a bacterial infection which situations it?
Upper respiratory tract infection broadly divided into three categories: acute otitis media, acute sinusitis, acute pharyngitis. Each criterion was as follows.
Bacterial Otitis Media: middle ear effusion and inflammation such as moderate or severe bulging eardrum, or a non-ear fluid leakage caused by otitis externa, or mild bulging eardrum plus or earache eardrum inflamed.
Bacterial sinusitis: symptoms get worse, or very serious. What symptoms worse it? Specific emphasis is the new fever and daytime cough, runny nose or early viral infection after a period of what is it serious? Fever above 39 degrees, or purulent nasal or cough or nasal discharge more than 10 days and no improvement.
Bacterial pharyngitis impatient: Analyzing bacterial pharyngitis is throat smear or culture needs to be done, and only two or more of the following occurs, it is recommended to do bacteriological examination: fever, swollen tonsils or bleeding, tenderness or swelling of the lymph nodes of the neck before, no cough. With special emphasis on not empirical medication.
2. If, as mentioned above confirmed bacterial infection, antibiotics should be considered before using the specific advantages and disadvantages balance benefits and side effects. Only under the following circumstances use of antibiotics is beneficial:
Bacterial Otitis Media: Only a very strict definition of otitis media, NNT (number needed to treat) is 4, that is to say, you need to treat four patients in order to have a person to benefit (NNT is a complex medical concepts, without detailing). Antibiotics to avoid complications no effect.
Bacterial sinusitis: Again only strictly defined clinical sinusitis, usually works in 3 days and 14 days after treatment. Antibiotics to avoid complications no effect. That is, many people think that "no medication will deteriorate," the idea of the opposite.
Acute pharyngitis: only determine whether the benefits of group A streptococcal pharyngitis have the infection. Antibiotics can shorten the course, avoid scarlet fever, also may be able to prevent further transmission to others. Antibiotics to avoid complications evidence is weak.
If you need to use antibiotics, the preferred amoxicillin, clavulanic acid alone or in Gac.
If a non determine the bacterial infection, the use is not anything useful, but lead to diarrhea, dermatitis, pseudomembranous colitis, drug-resistant.
3. The correct medication.
Bacterial Otitis Media: For children over 2 years of age, unilateral otitis media, no serious symptoms, consider observation (without medication). For treatment, the short-term treatment (7 days).
Bacterial sinusitis: symptoms for children with long-term sustainability, consider observation.
Acute pharyngitis: once daily amoxicillin.
Not recommended to use third-generation cephalosporins or azithromycin.
Of course, I'm just a rough translation of the principle of changing the clinical situation, we need to treat specific conditions. Please read the details of the new guidelines of the CDC and AAP carefully. Parents also do not judge their own medication, consult your pediatrician. But these principles as a basic guideline for those who like the frequent use of antibiotics parent or adult, can be considered a guide to action, and do not be stronger than the doctor prescribed antibiotics.
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