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| |    Antibiotic Myths by George H. McCracken, Jr., M.D. reviewed by Laura Jana, M.D., F.A.A.P. Since almost everyone has had some experience with antibiotics, myths and rumors abound about both their good and bad properties. On one hand, someone may falsely attribute a cure to an antibiotic when there is no way it could have affected the outcome. Such false information has fueled demand for inappropriate use of antibiotics since they first became available, and has been an important factor speeding the development of antibiotic-resistant bacteria. Conversely, antibiotics often are blamed for problems they didn't cause. Because antibiotics usually are given to people who already are ill, it's easy to see how they might be blamed for symptoms that are due to the illness itself. Myths originate from personal experience and bias, as well as from some direct-to-consumer advertising by pharmaceutical companies and articles written for the lay media--including the Internet. Some of the most common myths about antibiotics are as follows: Myth: Antibiotics weaken the body's immune system. Fact: Antibiotics do not weaken the immune system. This myth stems from the observation that a few people go on to develop new infections after having taken an antibiotic. Since no antibiotic can kill all kinds of bacteria, sometimes the initial infection is cured, but another infection develops from bacteria that are resistant to the antibiotic. Myth: Some antibiotics are stronger than others. Fact: Antibiotics are not stronger or weaker than each other, but they do differ in two important ways that determine whether or not they are likely to work for a given infection:
In general, providers try to choose antibiotics whose activity is limited to the most likely bacteria causing the illness (or narrow-spectrum antibiotic coverage), so that normal bacteria in the body are disturbed as little as possible. However, if a child is seriously ill and there is a wide range of possible causes, the provider will choose an antibiotic, or a combination of antibiotics, that has a broad range of activity (or broad-spectrum antibiotic coverage). For infections like ear infections, a provider will choose the drug that is most likely to work for initial therapy, but if that antibiotic doesn't work, she will try another. If the second antibiotic works, it should not be considered stronger or more potent, but simply more effective against the particular bacteria causing the current infection. Myth: If an antibiotic did not work for my child before, it won't work now. Fact: Just because a certain antibiotic didn't help your child before doesn't necessarily mean it won't work this time. The normal colonies of bacteria that reside in a person's body can change over time, and have different resistance and sensitivity patterns to specific antibiotics. Myth: Our bodies develop resistance to antibiotics. Fact: It is widely believed that a child will build up immunity or innate resistance to antibiotics that makes it necessary to use stronger drugs for subsequent infections. The real reason an antibiotic does not always work for a subsequent infection is that it may have killed the susceptible bacteria in the child's body but permitted resistant bacteria to flourish and cause the new infection. If this is the case, another antibiotic will be needed. A course of antibiotics usually only changes the body's bacteria (or normal flora) temporarily. Often by the time the next infection develops, the body will be colonized by bacteria that are susceptible to the original antibiotic. Myth: Antibiotics are needed any time a child has a fever because it might be due to a bacterial infection. Even if it is certainly a viral infection, antibiotics are still necessary to prevent secondary bacterial infections. Fact: The vast majority of infections in children are caused by viruses, and these infections resolve completely without antibiotics. Overuse of antibiotics for viral infections can set up your child for developing secondary bacterial infections that are resistant to commonly used antibiotics. These infections can be much harder to treat and may require intravenous (in the vein) antibiotics or treatment with multiple drugs. Myth: Antibiotics make children sleepy or tired. Fact: The infections make children tired, not the antibiotics. Remember, it is likely that one of the reasons you sought antibiotic treatment for your child is that he looked tired and sick.
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