Children’s Antibiotics: 8 Facts Every Parent Should Know

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Children's antibiotics are the most commonly prescribed group of medications for kids. When used correctly, they can be extremely effective at treating bacterial infections. But they're not helpful against illnesses caused by other types of germs, including viruses. In fact, taking antibiotics unnecessarily can be harmful.

If your child's pediatrician or other healthcare professional prescribes them an antibiotic, you may have questions about why it's needed, how long it will take to work, and the potential side effects. Here, we'll discuss eight things to know about children's antibiotics.

1. Children's antibiotics only treat bacterial infections

One of the most important things to know about antibiotics is that they only treat infections caused by bacteria. Common examples of childhood bacterial infections that are treated with antibiotics are:

• Strep throat

• Ear infections caused by bacteria

• Urinary tract infections (UTIs)

• Bacterial skin infections like impetigo

Viral infections - including COVID-19, the flu, and respiratory syncytial virus (RSV) - can't be treated with antibiotics. But telling the difference between a viral infection and bacterial infection can be tricky.

Sharing details about your child's illness will help their healthcare professional determine what type of infection your child most likely has. In some cases, they may recommend against using antibiotics right away, and instead opt to wait a few days to see if the infection improves on its own.

2. There's no single children's antibiotic that's best

There isn't one antibiotic that treats all childhood infections. When deciding which antibiotic is best for your child, your child's healthcare professional will consider many factors, including your child's:

• Symptoms and severity of their sickness

• Age

• Other health conditions

• Allergies

• Other medications

• Ability to swallow pills or willingness to take liquid medication

• History of taking antibiotics

They'll also consider whether your child may have been exposed to specific germs. For example, they may ask if other kids at your child's school are sick.

3. Certain antibiotics are more commonly prescribed for kids

Some antibiotics are more commonly prescribed for children than others. These preferred antibiotics may be safer for children or better at treating common childhood infections. Here's a list of commonly prescribed antibiotics for children:

• Penicillins, such as amoxicillin (Amoxil) and Augmentin (amoxicillin / clavulanate)

• Cephalosporins, such as cefdinir and cephalexin

• Macrolides, such as azithromycin (Zithromax)

• Clindamycin (Cleocin)

• Bactrim (sulfamethoxazole / trimethoprim)

• Topical antibiotics, such as mupirocin (Centany)

4. Knowing what questions to ask your child's prescriber can help keep your child safe

If your child's healthcare professional prescribes them an antibiotic, asking the right questions can help you feel at ease - and keep your child safe. Here are some questions you might ask:

• How long will they need to take the antibiotic?

• How many times a day should they take the antibiotic?

• Should they take the antibiotic with food? Are there any foods or drinks to avoid?

• Does the antibiotic interact with any other medications they take?

• What side effects should I watch out for?

You can also ask your pharmacist these questions when you pick up your child's antibiotic. Additionally, your pharmacist can tell you how to store the antibiotic and provide extra measuring devices for a liquid antibiotic if needed.

Other questions to consider asking your child's prescriber include:

• How soon do you expect my child to start feeling better?

• What should I watch for that could indicate the infection is improving or getting worse?

• When can they go back to school or day care?

• Do they need a follow-up appointment?

• Should they take probiotics during or after their antibiotic course?

After your child starts taking the antibiotic, they should start feeling better within 1 to 3 days. If your child doesn't improve, let their prescriber know. They may recommend a different antibiotic or look into other causes. If at any point your child has symptoms that seem severe, such as difficulty breathing or chest pain, seek emergency care.

5. There are ways to help your child take their antibiotic

First and foremost, make sure your child takes alltheir prescribed doses. Here are a few strategies to make sure this happens:

• Putting a reminder on your phone or the fridge about timing for the doses

• Teaching anyone caring for your child when and how to give them the antibiotic

• Noting the date your child started taking the antibiotic and the date they should finish treatment

It's possible that your child will have leftover medication (especially if it's a liquid antibiotic) after they finish their prescribed course. You can dispose of leftover doses in your household trash, but it's best to first put the medication in a plastic bag with coffee grounds, kitty litter, or dirt. Another option is dropping it off at a medication take-back site.

If your child is very young, check out this GoodRx Health article on how to get your toddler to take medication. One trick is asking your pharmacist to flavor your child's liquid antibiotic. You can also ask them whether it can be mixed with food or drinks to make it taste better. Enlisting siblings to distract your toddler while they take an antibiotic can also help.

If your child is older, it's still a good idea to be around when they take their doses. If they're taking the antibiotic on their own, make sure they understand how to take it and how long their treatment will be.

6. Most antibiotic side effects are mild, and there are often ways to manage them

Side effects vary depending on the antibiotic. But in general, many antibiotics can cause:

• Nausea

• Diarrhea

• Indigestion

• Headaches

• Nasal congestion

• Muscle aches

• Dizziness

• Yeast infection or oral thrush

Gastrointestinal (GI) side effects like nausea and diarrhea are usually mild and go away after treatment ends. But giving your child their doses with food can help minimize GI side effects, if your pharmacist says it's OK. And sticking with simple, gentle foods can also help settle an upset stomach.

The BRAT (bananas, rice, applesauce, and toast) diet is helpful for mild diarrhea. And there's evidence that probiotics can prevent antibiotic-associated diarrhea. In fact, the American College of Gastroenterology recommends considering certain probiotic strains for children taking antibiotics to prevent a Clostridioides difficile (C. diff)infection, which is discussed below. Talk to your pharmacist or your child's prescriber about whether they recommend a probiotic and how long your child should take it.

7. In rare cases, antibiotics can cause serious side effects

Allergic reactions and severe diarrhea are two serious antibiotic side effects to watch for. And knowing what to do if they happen will help keep your child safe.

Allergic reactions

Most antibiotic-related skin rashes are mild, but they often indicate an allergic reaction. If your child develops a rash after taking their antibiotic, have them stop taking it and contact their prescriber immediately. If the rash is painful, blisters, or spreads quickly, seek emergency care. You should also seek emergency care if they experience any other severe symptoms of an allergic reaction, such as trouble breathing, facial swelling, or hives.

C. diff infection

In rare cases, antibiotics can lead to a C. diffinfection. Let your child's prescriber know right away if your child has severe diarrhea or stomach pain with a fever, as this could be a sign of infection. C. diff infections can happen while taking antibiotics and up to 8 weeks after antibiotics have been stopped.

8. There are things you can do to help prevent antibiotic resistance

When an antibiotic stops working against infections it used to effectively treat, the bacteria that causes these infections is referred to as "antibiotic-resistant." Antibiotic resistance is a growing problem worldwide.

This doesn't mean antibiotics shouldn't be taken when necessary. But according to the CDC, about 25% of prescribed antibiotics aren't actually needed. So ask your child's prescriber to explain why they're recommending an antibiotic if you're unsure. And make sure your child finishes their full course of medication so that their infection is fully treated.

Keeping your child up to date with their vaccinations and reminding them to practice good hand hygiene can help lower their chances of getting infections and needing antibiotics.

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