Amanda Bryan
Samantha Thiele
Microbiology
Policy Paper
1 October 2009
Prescribing Antibiotics for Childhood Illness
Background:
When a parent brings a child into a doctor’s office, is the child being treated for what the doctor thinks is wrong or what the parent believes is wrong? According to the Centers for Disease Control and Prevention (CDC) website, if the doctor says antibiotics are not needed, the parents should not be able to persuade the physician to prescribe them anyway (1). Prescribing unneeded antibiotics in young children can cause school-aged children to acquire asthma. According to one study, each antibiotic course doubles this chance. Also, the overuse of antibiotics does not allow the immune system to kill bad bacteria on its own, so that when a person is not on them, the immune system would over react to normal environmental bacteria (2). Different studies have shown that up to 90% of children presenting with common cold, upper respiratory tract infection, or acute bronchitis received antibiotics (3). There are many ways to prevent over prescribing antibiotics for viral infections.
Strategy:
To prevent overuse of antibiotics, Siouxland District Health officials could make a policy that “If the doctor believes any patient has a viral infection, he or she shall not prescribe antibiotics for the infection.” They can also give their patients a brochure explaining the policy and the difference between a bacterial and a viral infection. This will help tremendously when telling parents that they cannot give their child an antibiotic because it will not help. It will list some common ailments that antibiotics will not cure like sinusitis, sore throat, common cold, runny nose, bronchitis and some ear infections (4). Patients would not have a choice because it is at the doctor’s discretion whether or not they believe an infection is viral or bacterial. The brochure will include what happens when doctors over prescribe antibiotics such as antibiotic resistance. It would explain instead of antibiotics, the sick person or, in the case of a child, their parents can perform symptom relief. This means treat symptoms and let the virus run its course. This includes drinking fluids, getting plenty of rest, and antipyretics, such as acetaminophen and ibuprofen.
The cost such a policy would be minimal. The only cost associated with this policy would be the cost of paper and printing. Therefore, there would a cost of $0.10 a page to print 1500 brochures and pass out approximately 200 brochures to each doctor’s office and clinic in Sioux City.
Conclusion:
By implanting this policy and related brochure, instance of over prescribing antibiotics should decrease in time. A concern of the patient may be that the doctor is unsure whether the infection is bacterial or viral. However, doctors are licensed professionals trained to distinguish between different kinds of illness and prescribe what they deem an appropriate treatment for them. Another concern may be that patients or parents may travel from doctor to doctor until they receive an antibiotic for themselves or their child. This is not really something that can be prevented however if all doctors in the area abide by the policy this exception should be avoided.
References:
1. “Get Smart: Know When Antibiotics Work”. Centers for Disease Control and Prevention.
2. Potera, Carol. “Children’s Health: Do Antibiotics Now Mean Asthma Later?” Environmental Health Perspectives. PubMed Central. June 2006.
3. Huang, Nicole, et al. “Antibiotic Prescribing for Children With Nasopharyngitis (Common Colds), Upper Respiratory Infections, and Bronchitis Who Have Health-Professional Parents”. Official Journal of the American Academy of Pediatrics. Oct 2005.
4. Nash, David, et al. “Antibiotic Prescribing by Primary Care Physicians for Children with Upper Respiratory Tract Infections”. Archives of Pediatrics & Adolescent Medicine. Nov 2002.
