Antibiotics Are Not for Everyone

When we are headed into the cold and flu season, I am practically bowled over parents wanting antibiotics for their child who has the sniffles and a fever for 1 day. Sorry, but you have a virus and even if I did feel like just appeasing you, antibiotics would do nothing.

Why is it so hard to get your provider to prescribe antibiotics? Resistance.

Antibiotic resistance is a big deal. Overuse of antibiotics like amoxicillin (pink bubble gum medicine) and azithromycin (z-pak) has lead to some serious issues with antibiotics and bacterial illness. It isn't our bodies that build resistance, it is the bacterial germs. Which means if someone is improperly prescribed an antibiotic, they can develop resistant germs and spread them like wild fire. (Think daycare, school, the mall, the doctors office!!) So, if your kid has what looks like a virus, then I'm not going to give them antibiotics.

Here are some tips on knowing when a child might need antibiotics for cold like symptoms and when they don't:

6+ months old : Fever (100.4 F) x 72+ hours - or - a fever that doesn't improve with acetaminophen or ibuprofen. Typically fevers from viral infections resolve after 48 hours. If they are still running a fever, a visit to the doctor to see if antibiotics are needed is warranted. (Less than 6 months with a fever, go to the doc right away)

Cold symptoms x 7+ days that are not improving at all

Painful tugging on ears (this one is tricky because teething babies do this a lot)

Very red, sore throat, especially with white stuff on the tonsils or in combination with a rash.

Streaks of blood in boogers

When they don't:

Green -or- Yellow Snot- the color of snot is an indication of how dry the mucus is, not an infection. The rainbow of snot progresses as follows (moist-dry): clear, cloudy, white, yellow, green. Boogies will turn green even from allergies if they are stuck up the nose long enough. So break out the nasal saline (or put some epsom salt in the bath tub & blow bubbles with the nose) and clear those boogies out. :)

Diarrhea- rarely does diarrhea require treatment with an antibiotic. In fact, most antibiotics make diarrhea worse. If diarrhea lasts for more than a week or has blood or mucus, then more investigation needs to be done at the doctors office.



So happy cold season everyone. I promise your best tools when the boogers and coughing start are nasal saline, lots and lots of water, extra pillows at night, a humidifier and some good old chicken noodle soup.

Don't get me wrong. I am happy to see babies and kids at any point in their illness, make sure they just have a cold and offer suggestions for anyone who will listen. Just remember, not every illness can be cured with antibiotics.

***Please remember, this is just my opinion and does not replace a visit or phone call to your own pediatricians office under any circumstance ***

Don't play with Q-tips!

Many of us grew up using q-tips, usually for cleaning our ears. I even thought my grandmother was crazy when she told me not to use q-tips because, “they are dangerous.” Boy was she right! And no, infant safety q-tips aren’t any better.

In my opinion, Q-tips are great for pretty much 3 things: cleaning belly buttons, removing makeup and touching up nail polish.

I can’t tell you how many Q-tip disasters I have seen in the office, but I’d be happy to list the top few for you.

1. Impacted Cerumen (medical words for wax shoved so far, and so deep in a kids ear that it is practically impossible to get out) - Parents, kids, and teens will use Q-tips to, supposedly. remove wax from their ears. What they don't realize is that our bodies naturally make us stop when it hurts to prevent damaging the ear drum, thus we stop short of removing the wax and just push it back further. Removing wax that has been repeatedly pushed farther and farther into the ear canal is both a nightmare for your child and your pediatrician. Leave the wax removal to us, or use hydrogen peroxide.
2.  Nasal Foreign Body (i.e. Q-tip up the nose) – Babies and kids just LOVE shoving stuff up their nose and you would be surprised by how far they shove it up their nose, how quietly they do it and how long it takes to figure out there is something up there. Think DAYS, funny smells you can’t quite put a finger on (haha, pun intended) and lots of clear/green/bloody goop coming out of their nose. Oh, and a trip to the ENT to have it removed.
3. Ruptured Tympanic Membrane (yup, poking a hole right in that sweet little ear drum) – The thought process is, “I’ve seen Mom/Dad do this. I think I will give it a try. Hey Sis, come here; let me experiment with this Q-tip. Ahhhhh, why is she screaming!”

If you really want to get the wax out of an ear use hydrogen peroxide, yup hydrogen peroxide.  (Or as I like to call it, the snap, crackle and pop method.) Just lay the kiddo down in front of the T.V., fill the ear with hydrogen peroxide, let it sit for 10-15 minutes and then repeat on the other side. Afterward put them in the bath and use the warm bath water (and maybe the blue nose sucker from the hospital) to rinse out the chunks of wax. *** If your little one has tubes in their ears, this is not recommended ***

On a side note, earwax build up can lead to an increased risk for “swimmer’s” ear, or even “bath-tub” ear. The water gets stuck inside a nice warm place and makes a perfect home for fungus and bacteria to grow. Leading to a painful infection of the skin in the ear canal. The usual symptom of swimmer’s ear is an ear that is painful to the touch on the outside. The best way to prevent swimmer’s ear is to keep ears free of excessive wax build up and to use a solution of 50/50 vinegar and rubbing alcohol to dry them out after getting wet. I tell a lot of parents to just mix some up at the beginning of the summer and use it after every time the child goes swimming to stop the problem before it starts. (Warm drops are less irritating than cold ear drops, so bring the solution with you into the sun so it can warm up a little bit) Once there is pain, it is time to go to the doctor for proper treatment and diagnosis.

Remember, this is just my daily soapbox. My opinion does not necessarily reflect the same opinion of your child’s physician and does not ever replace a visit or phone call to the pediatricians office.

Safety First!

Megen, PNP