Not so long ago I had a father in my office. He was also a general practitioner who trained in the Middle East. One of his concerns was that his 4 year old daughter received numerous antibiotics—and strong ones–in the past. He felt the doctors who cared for her over-prescribed antibiotics and questioned if this may have caused liver disease.
In addition I often see patients who were seen in what is known as “Walk-in Clinics” These clinics are convenient to use but the doctors who work there may not always be experienced or comfortable looking after children. Some doctors who work there are very good though and recently a mom told me that such a doctor told her “Here is a prescription for an antibiotic but aim to not use it unless the child gets worse”. A good idea.
Recently the American Academy of Pediatrics ( AAP ) reminded us that three simple principles must be applied when the use of antibiotics for Upper Respiratory Tract Infections is considered.
1. For middle ear infections watchful waiting for children aged 2 years or older could be applied.
2. For sinusitis use antibiotics only if the symptoms get worse or have lasted more than 10 days.
3. For pharyngitis use antibiotics only after the lab confirmed it was indeed a strep throat.
The use of broad-spectrum antibiotics for the above conditions is discouraged by the AAP.
I also tell my patients to use probiotics for at least one month after they were placed on antibiotics. That way the good bacteria in the gut gets restored. Prebiotic foods are also a good idea. These are bananas, asparagus, onions, oats and raisins.
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