Jonesboro Kids Blog

Antibiotics

Antibiotics are medicines used to treat infections caused by bacteria. Most physicians are hesitant to prescribe antibiotics over the phone. Many types of illnesses do not benefit from antibiotics and may actually be made worse by taking them. Antibiotics are effective only against bacterial illnesses and have no effect on the course of viral illnesses such as the common cold, the flu and viral gastroenteritis (vomiting and diarrhea). An accurate diagnosis is essential to determine not only if your child needs an antibiotic, but also to decide which antibiotic will work best. We therefore recommend that you make an appointment and have your child evaluated by a physician if you feel your child needs an antibiotic.

Taking an antibiotic for nonspecific symptoms such as fever, cough, sore throat or cold symptoms may not only be unnecessary, but may delay the diagnosis or mask a more serious illness. For this reason, it is recommended that you do not give your child leftover medications or use an antibiotic prescribed for someone else. It is recommended that the full course of antibiotics be completed as prescribed, to help prevent the development of resistant infections.

Just as with any medication, antibiotics have potential side effects. If your child is placed on an antibiotic, you should observe him/her for possible side effects.

SIDE EFFECTS:

The most common side effect seen with antibiotic use is gastrointestinal (stomach) upset causing diarrhea and/or vomiting. Mild diarrhea is of little concern. Sometimes yogurt, sweet acidophilus milk or Lactinex granules (one packet four times per day) can restore the bowel’s normal environment which the antibiotic disrupted causing the diarrhea. If the diarrhea is severe or is associated with rectal bleeding, you should contact your physician. If vomiting occurs with antibiotic use, make sure you are properly administering the antibiotic. Some antibiotics are required to be taken with food. If this is unsuccessful at stopping the vomiting, you should call your Physician’s office. Your child may also have a side effect to an antibiotic manifested by an allergic rash. There are several different types of allergic rashes seen with antibiotic use. It is also common to have rashes caused by viruses during treatments with antibiotics. Because of these factors, it is impossible to evaluate rashes by telephone. You should do the following if your child develops a rash while taking an antibiotic:

1. Stop the antibiotic and make an appointment for your child during normal office hours.
2. Administer Benadryl (per package instructions; for dosing for children less than 6 years of age please contact your physician for dosing instructions). This may help to resolve the rash and will help with itching.
3. You should contact your physician immediately for any breathing difficulty associated with an allergic rash.

Antibiotics can cause secondary yeast infections in the mouth with little white bumps called thrush (refer to the section on Mouth Injury), and in the diaper area causing a diaper rash or diaper dermatitis. If your child develops a thrush and/or diaper rash from taking an antibiotic, contact your physician’s office during regular hours.

It is possible for bacteria to develop resistance to antibiotics to which they are exposed for long periods of time. Most often, antibiotics are prescribed for only ten days, thus limiting this development of resistance. Certain types of infections such as sinus and recurrent ear infection require a longer course of treatment. Although resistance to antibiotics does sometimes develop, it is a problem which can usually be taken care of by switching to a different class of antibiotics or by giving higher doses.

Although, taking antibiotics for long periods of time is not without some risk, it is riskier to have an infection which is either untreated or under-treated. Long term consequences from prolonged antibiotic use are quite rare.

Antibiotics are wonderful drugs and have probably saved more lives than any other class of medication. They are not a cure-all however, and are not without risk. They should only be used at the direction and under the supervision of a physician. Old antibiotics or a partial prescription should not be taken without checking first with your physician.

Home Medications

It is important to have your medicine cabinet well supplied to be able to effectively deal with illnesses and accidents when they occur. The following is a list of commonly used medications and supplies which you may find useful to keep on hand. Keep all medication and/or potential poisons such as cleaners in locked cabinets out of reach of children.

1. Acetaminophen (Tempra, Tylenol) – This comes in several forms from drops to chewable tablets. It is used for pain and fever control. Dosage chart
2. Ibuprofen (Motrin, Children’s Advil Suspension) – This medicine is an effective alternative at relieving fever. For older children and adults ibuprofen tablets (Nuprin, Advil) are available over-the-counter. Dosage chart
3. Mycitracin, Polysporin Ointment – This is used for treating cuts, scrapes and superficial skin infections.
4. Syrup of Ipecac – This medicine is used to induce vomiting (an emetic) in case of certain accidental poisonings. It should only be used on the direct advice of a physician. Vomiting should not be induced for all types of poisonings. Please see the section on poisonings.
5. Benadryl (Diphenhydramine) – This antihistamine medication is used for allergic reactions and itching. Dosage chart
6. Infalyte or Pedialyte – This carbohydrate and salt solution is used to treat vomiting and diarrhea in children.
7. The following health aids are useful: Bandaids, gauze 4X4’s, thermometer, tweezers, scissors and white tape.
8. If your child has a history of chronic ear infection, you may want to keep Auralgan Otic drops (or equivalent) – These deaden ear pain when placed in the ear. If your child has ear tubes (pressure equalizing tubes) or has an ear infection with pus or blood draining from the ear, you should not use Auralgan, but should contact your physician.

First Aid Kit

A well-stocked first aid kit is a handy thing to have. To be prepared for emergencies:

• Keep a first aid kit in your home and in your car.
• Carry a first aid kit with you or know where you can find one.
• Find out the location of first aid kits where you work.

First aid kits come in many shapes and sizes. Your local drug store may sell them. You can also make your own. Some kits are designed for specific activities, such as hiking, camping or boating.

The American Red Cross recommends the following items for a family of four:

• 2 absorbent compress dressings (5 x 9 inches)
• 25 adhesive bandages (assorted sizes)
• 1 adhesive cloth tape (10 yards x 1 inch)
• 5 antibiotic ointment packets (approximately 1 gram)
• 5 antiseptic wipe packets
• 2 packets of aspirin (81 mg each)
• 1 blanket (space blanket)
• 1 breathing barrier (with one-way valve)
• 1 instant cold compress
• 2 pair of nonlatex gloves (size: large)
• 2 hydrocortisone ointment packets (approximately 1 gram each)
• Scissors
• 1 roller bandage (3 inches wide)
• 1 roller bandage (4 inches wide)
• 5 sterile gauze pads (3 x 3 inches)
• 5 sterile gauze pads (4 x 4 inches)
• Oral thermometer (non-mercury/nonglass)
• 2 triangular bandages
• Tweezers
• First aid instruction booklet

Source: The American Red Cross – Anatomy of a First Aid Kit

Recommended Immunizations

Immunizations are a very important tool in preventing serious childhood diseases. In many states, immunizations are required prior to school admission. It is imperative that you keep an immunization record for each of your children. This record should be completely up-to-date and always available. It is a good idea for parents to keep this information with them. It is your responsibility to always keep up with your child’s immunization records because this may be very important at the time of accident or illness.

“DTP/DTaP Vaccine”

DTP (Diphtheria, Tetanus, and Pertussis) vaccine has been administered to healthy children in the U.S. for more than 40 years. It is a killed cell vaccine (components from the bacteria are used to make the product). The vaccine is given at 2, 4, 6, 15 to 18 months, and at 4 to 5 years of age. Potential minor side effects occur in about 1/3 of children, and consist of low grade (less than 102 degree) fever, local soreness or swelling at the injection site, or irritability. These are self limited, beginning within hours of the immunization and lasting less than a day. A small knot at the site may persist for several weeks before resolving. Tylenol or other brand of acetaminophen (see dosing guide) may be used to minimize these symptoms. Rarely, (about one chance in 3,000), a more severe reaction may occur, such as a high (more than 105 degree) fever, convulsion, or an extreme weak, pale appearance. These problems are also temporary, but are frightening and your child’s physician should be notified immediately if these occur. DTP has also been associated with a very rare risk of long term injury. However, when compared to the hazard of death or damage from the disease Pertussis, normal healthy children are felt to be far safer with the vaccine despite the above risks. A new approved vaccine is the DTaP – (Diphtheria, tetanus, and acellular pertussis) vaccines are efficacious when administered to infants as the primary series (i.e., doses 1-3). In addition, local reactions, fever, and other systemic events occur substantially less often after diphtheria, tetanus, and acellular pertussis (DTaP) administration than after administration of whole-cell diphtheria, tetanus, and pertussis (DTP). Therefore, diphtheria, tetanus, and acellular pertussis (DTaP) vaccines are recommended for all five doses in the vaccination schedule. For children who have started the vaccination series with one, two, three, or four doses of whole-cell diphtheria, tetanus, and pertussis (DTP); diphtheria, tetanus, and acellular pertussis (DTaP) is also recommended for all remaining doses in the schedule. During the period of transition from use of whole-cell diphtheria, tetanus, and pertussis (DTP) to diphtheria, tetanus, and acellular pertussis (DTaP), whole-cell diphtheria, tetanus, and pertussis (DTP) is an acceptable alternative to diphtheria, tetanus, and acellular pertussis (DTaP) for any of the five doses.

“Polio Vaccine”

Polio vaccines have been routinely administered to U.S. children since the 1950’s, and they have produced the elimination of paralytic polio in our country. The vaccine in use is the Inactivated Polio Vaccine, and this is given at 2 and 4 months of age followed by booster doses at 12-18 months and 4-5 years.

“MMR (measles, mumps, rubella)”

The MMR is also a live virus vaccine, and it is given by injection at 12-15 months of age, with a booster dose at age 4-6 years. Severe side effects are extremely rare, but children can occasionally develop a measle-like rash and/or low grade fever from 1-2 weeks after the immunization. This reaction is typically brief and self limited, and requires nothing more than acetaminophen for treatment. The same precautions as those for oral polio vaccine also apply to the MMR since both are live vaccines. Also, children highly allergic to egg might possibly react to MMR. Let your doctor know about possible egg allergy prior to immunization.

“HIB (Hemophilus influenza type B vaccine)”

This immunization prevents serious infections due to the H flu bacterial germ, the most common cause of spinal meningitis in childhood. The HIB vaccine has been routinely given to all children for about a decade, and is now combined in the same shot with DTP vaccine. This vaccine is extremely well tolerated.

“Hepatitis B”
This vaccine is given to protect your child against the Hepatitis B virus, which can cause problems with the liver. This vaccine is given as a series of three doses, with the first right after birth, the second dose 1-2 months after and the last 6 months later. This is also a vaccine with a very safe track record.

“Chickenpox (Varivax)”
Chickenpox vaccine is the newest addition to the routine childhood immunization series. This is a live virus vaccine (similar to MMR) and is recommended for every child older than age one who has not had chickenpox. It is given as a shot and consists of a single dose to younger children, or a two dose regimen if the child is 13 years or older. Side effects are few and consist of occasional soreness at the site of injection, mild flu-like symptoms, or rarely, a few chickenpox spots. The same precautions should be observed as for the polio vaccine.

“Prevnar”
Prevnar is a pneumococcal vaccine, which helps prevent childhood diseases caused by the bacterium Streptococcus Pneumoniae. These infections are the most common invasive bacterial infections in children. Prevnar is recommended for use in all children 23 months of age and younger and for children ages 24-59 months who are at high risk of invasive pneumococcal infection. Since the immunization schedule depends on when your child receives their first dose, see your physician for their recommendations.

“TB Skin Test”
This is not an immunization, but is a test that is done to determine whether your child has been infected with tuberculosis, a chronic and severe lung disease. It is sometimes a part of routine health visits at 12-15 months of age, and is definitely indicated if a family member has the disease.

“Tetanus”

Tetanus (lock jaw) is a disease which is caused by a bacteria which can grow in contaminated wounds. The bacteria can produce a toxin or poison which causes serious muscular spasms. Dirty wounds (those contaminated with dirt, feces, soil and/or saliva), or deep puncture wounds are particularly tetanus prone. Universal immunization with tetanus vaccines has virtually wiped out tetanus in the United States. Children who suffer more serious wounds should have particular attention paid to their immunization status. If your child has had three or more DTP vaccine doses within the past 5 years, then he/she does not require tetanus immunization after a dirty wound. If 5 or more years have elapsed since the last immunization to tetanus, then a booster will be required at the time of the injury. Children and adults should receive a tetanus immunization at least every ten years even if no wounds have occurred.

Ibuprofen

Dosage: Every six to eight (6-8) hours.

When To Use: Ibuprofen should be used to control high fevers which are unresponsive to acetaminophen. It can also be used to control pain and reduce inflammation.

Side Effects: May cause upset stomach, other side effects are rare.

SHOULD NEVER BE ADMINISTERED TO CHILDREN UNDER THE AGE OF 6 MONTHS.

Benadryl

Dosage: Every four (4) hours.

When To Use: Benadryl is an antihistamine medication which is particularly good at relieving allergic symptoms. Use Benadryl for nasal congestion, sneezing, runny nose, itching of the nose and throat, itchy watery eyes or other respiratory allergies due to hay fever. Iti s also useful to treat itching due to any cause. Use Benadryl to treat insect bites and stings.

Side Effects: May cause drowsiness, or less commonly, agitation or insomnia. Other side effects are rare.

Children over the age of 12 years and adults may take Benadryl tablets or capsules 25mg, one (1) every six (6) hours..

Acetaminophen

Dosage: Every four (4) hours.

When To Use: Acetaminophen should be used to reduce fever and relieve pain. Acetaminophen has no anti-inflammatory actions.

Side Effects: Unlike ibuprofen and aspirin which can have rare but potentially serious side effects, acetaminophen is very safe. Only if an overdose of the medication occurs is there a likelihood of any side effect. If your child takes an over-dose of acetaminophen call your physician or poison control center immediately.

If a child has a particular high fever, increase the dosage only on the advice of your physician due to the risk of overdose and liver damage.