3) Is this really a big problem?

Yes. The more that bacteria grow resistant to antibiotic drugs, the less

useful weapons we will have in the arsenal in our fight against infection. History has already sent clear messages about the rapid growth of resistance and its dangers. According to an article in the Medical Reporter by Kenneth Gershman, MD, MPH, the bacterium Streptococcus pneumonaia (SP), “was universally sensitive to penicillin up until the late 1960s when the first reports of resistance began to appear.” Dr. Gershman explains that by 1995, in some parts of the country, 30% of all cases of SP were resistant to penicillin. This striking rise in resistance, in less than forty years, indicates the certain danger to come.

Being infected by a resistant strain of bacteria is a severe problem. The symptoms of such an infection are likely to be more severe, last longer, and require larger doses of antibiotics than an infection with an older strain of the same bacteria. In the gravest cases of infection, the antibiotics may require intravenous administration. Eventually, though, even higher doses of antibiotics will cease to do the trick. As the bugs get closer to winning this battle, deaths from serious infection will begin to increase. Children are particularly at risk as children have the highest rates of infection, are generally exposed to the most germs, and are least conscious of casual physical contact (such as borrowing a friend’s pencil after he has just sneezed on his hand etc.)

4) How quickly does resistance occur?

The transition to resistance can happen very quickly. We think of evolution as a very slow process, but human abuses of antibiotics put so many pressures on the bacterial population, that we are ultimately breeding out the bacteria we can fight. Humans are developing a super-breed of bacteria that may defeat us in the end. Recent studies by federal health officials suggest that resistance to the most common antibiotics such as penicillin has increased as much as 300% since 1992. This statistic demonstrates the alarming rate at which common bacteria develop resistance. This is a problem that we cannot afford to ignore one more year.

5) What cures will be available when antibiotics fail?

Antibiotics will eventually fail and when they do, we are in big trouble. They have become the cornerstone of our fight against infection for decades. We don’t have another option at this time, but we better come up with one soon. Losing the fight against bacteria is inevitable. Bacteria are evolving towards resistance at an unstoppable rate. At this point, the failure of antibiotics is not the question, slowing it is.

Research is being done toward other options to treat infections, but most of them are too distant in the future to hold much hope now. For the time being, we will need to use higher and higher doses of antibiotics in order to cure infections that were once easy to treat. Scientists are trying to continually develop newer versions of traditional antibiotics to be stronger and more specific to particular strains of bacteria, but eventually, most scientists agree, our resources will die out.

6) How can I help with the problem?

As parents, it is vital that we be conscious of how our behavior can affect our child’s medical future. There are many ways that parents can avoid contributing to the problem of antibiotic resistance. The term “Dr. Mom” has been tossed around in commercials, and it is important to know what is best for your child. Being able to diagnose your child, however, is a very different thing. Only a doctor can really tell you whether your child needs antibiotics or not.

Trust what your doctor says. Many parents argue with their pediatricians and demand medication. It is normal to want the doctor to do everything he can to help, but a prescription for antibiotics may do more harm than good. Remember that if your child has a viral infection, antibiotics will only make you feel better. They will do nothing to alleviate your child’s symptoms or condition. The pediatrician is unlikely to argue if you demand antibiotic treatment. He does not want to upset a client. Try to listen to his initial recommendation, and accept that it is unlikely that he would want to brush off your child’s problem as much as he would want to properly address the problem. There are ways you can make your child feel better and even get well sooner. Rather than being confrontational with your physician, ask him what you can do for your child in lieu of medication.

Beyond our behavior toward physicians, parents need to begin to break themselves of the antibiotic habit. Young parents were raised on antibiotics, and we have come to think of them as the only solution to illness. This, we know, is not true. There are many illnesses that will not respond to antibiotics at all.

Education is also a key weapon in the fight against antibiotic resistance. Talk to your doctor or pediatrician about resistance. Use his expertise as a chance to become well versed on the subject.

Actively research the problem yourself. There are numerous websites aimed specifically at helping the general public learn more about resistance. It is important to have a clear understanding of something that can, and will, pose a major threat to the future of American families. Learn about hygiene and prevention to stay a step ahead of the germs.

When prescribed, make sure your child takes all the medicine in the bottle. Don’t let a child stop taking the pills once he or she seems to be feeling better. Finishing the bottle insures all the infectious bacteria have been killed off, preventing him or her from passing them on to another child, and never save antibiotics for a rainy day.

7) What is the difference between a bacterial infection and a viral infection?

It can be very difficult at times to tell the difference between a bacterial infection and a viral one. It is best to seek the opinion of a doctor in any case where you feel your child’s condition may become more serious. As a rule, colds, the flu, most coughs and bronchitis, and the majority of sore throats, are viral and will not be affected by antibiotic treatment. The problem is that there is a lot of grey area. Telling the difference between a sinus infection, and a cold or flu may be very difficult without a doctor’s help.

Never give your child antibiotics on your own to treat any condition until you have seen a doctor. Strep throat is a condition that is bacterial yet acts just like a viral sore throat.

Never take chances with your child’s health. If you have any concerns about your child’s illness, take him or her to a pediatrician immediately.

8)How can I prevent infection in the first place?

Good hygiene has always been the best way to prevent acquiring an infection. Germs can only be spread when they are present. Frequent hand washing, changing out of dirty clothes, and keeping surfaces clean will all reduce the rate of infection. We have to learn to be aware of the bacterial world the same way we are aware of the dangers of crossing a busy street. There are millions of bacteria out there ready to run us over if we do not look before we step out into traffic.

Doctors recommend, good old soap and water. Simply washing a cut with hot water immediately after it occurs can prevent an infection from taking over. There are entire websites on the internet devoted to the issue of hand-washing. Thoroughly washing hands after using the bathroom, sneezing, or handling raw foods is an extremely effective form of prevention. Although bacteria are powerful once they invade the body, dangerous bacteria are easily kept away with proper hygiene. Children, especially, need extra help understanding the importance of hand washing. Germs, on the hand, can spread numerous kinds of infections. Hand washing with warm water and soap kills all of them. Bacteria cannot survive at higher temperatures. That is why they do so well in our bodies. Our bodies are cozy environments for germs, but they are not so hot that germs are chased away. Wash your hands with water that is as hot as possible (without burning your hands of course). Use hot water instead of depending on antibacterial soaps and hand lotions. These products may aid resistance in the same way that antibiotics do.

9) How can I teach my children about antibiotic resistance?

Education is essential in protecting yourself and your family against infection. Make conversations about hygiene and health just as important as other safety talks. Just as you wouldn’t want your child talking to strangers, because some strangers are not to be trusted, germs are just as untrustworthy, and your child should know how to keep them away.

Don’t dismiss the habits you ask your child to develop. Children should know why they are supposed to do the things we ask of them. There are good reasons why your child should wash up. When your child is sick, use his down-time as an opportunity to discuss infection in a way he can understand. Ask him if he likes feeling like this. Remind him that washing his hands after sneezing and coughing can keep his friends from getting sick. Be hands-on about it. Show him or her how to use warm enough water and remind him to use plenty of soap. Children like to go through the motions of brushing their teeth or washing their hands, but they are not being effective that way, and they need supervision until they learn how to wash-up correctly.

Be a good example. Never offer your child antibiotics that you keep around just in case. Always supervise your child’s medications.

10) How can I treat my child’s illness and make him feel better without antibiotics?

The most unfortunate part of our overdependence on antibiotics is that parents have gotten away from the traditional cures that mothers have been using for decades. These tried-but-true methods for treating sick children still work, and they could alleviate your child’s uncomfortable symptoms, as well as curing him.

Children are prone to fevers. Their small bodies get fevers more easily, and their body temperatures shoot up faster and higher than adults. Bringing your child’s fever down is essential to getting him well. Try giving him small doses of aspirin. The main ingredient in aspirin helps to reduce a fever. It will also help reduce a child’s aches and pains associated with a typical virus. Children’s chewable aspirin will be easiest to give to a resistant and uncomfortable kid. Crushing the pills into ice cream or jam usually will help get it down. Put your child in loose, lightweight clothing with few blankets. You don’t want to bundle up a kid with a fever. Wrapping your child up like that keeps his body temperature too high and keeps the fever from backing off. Cold compresses, cool soaks in the bathtub, and an alcohol rub over your child’s back all help with a fever as well. The cool soak and compress work simply by surrounding your child with a cool temperature. A drop in fever can quickly make a child feel better. Alcohol wiped over the back works through cooling evaporation. Alcohol evaporates more quickly than water, which allows it to work even faster against a fever.

Fluids are a classic solution to illness that works. The body needs to maintain a certain level of hydration at all times. When a child has a fever, he sweats more, and loses moisture more quickly. Dehydration dries out the mucus membranes, which can make recovery more difficult. Give your child plenty of water while he is sick. Tea and soda may be easier to get him to drink, but they wont work as fast to rehydrate his body. Some doctors recommend sports drinks with extra electrolytes in them. No matter what you use, just make sure your child is constantly taking in fluids while he is still sick.

If your child is throwing up, take it slow at first because anything you put back in the child’s system may make the vomiting start again. After the nausea passes a little, ice chips, or popsicles will soothe the back of the child’s throat, and treats tend to cheer them up and make them feel cared for.

Dr. Deborah Creswell, a family Psychologist, recommends keeping the entire body running smoothly. She encourages regular sleep, exercise and proper nutrition as the basic, but often overlooked, methods of preventing illness. Dr. Creswell also emphasizes stress reduction techniques such a meditation as a means of keeping the body’s immune system strong. Children do experience stress, and they are never too young to learn how to manage it.

The fight against bacteria may be a losing battle, but that is no reason that parents shouldn’t work to slow the problem down. Education, and a consciousness of the habits we all need to change will keep our very valuable antibiotics from failing as long as possible. By making a small effort to teach our kids about hygiene and to be a little more understanding with our family physician, we can help to maintain the effectiveness of antibiotics for the next generation.

Sources:

“A Future For Antibiotics?” BBC News 8 Oct. 1999

<http://news.bbc.co.uk/1/hi/health/background_briefings/antibiotics/468361.stm>

Allan, Wes. “Drugs Losing Their Punch Against Kids’ Infections” Saint Petersburg

Times 17 March. 2002 <http://www.sptimes.com/2002/03/07worldandnation/drugs_losing_their_pu.shl>

“Avoiding Resistance to Antibiotics—When Do I Need an Antibiotic.” American Family

Physician. 15 March 2001 <http://www.aafp.org/afp/20010315/1097ph.html>

“A new threat to your health: Antibiotic Resistance” Get Smart.

CDC Antimicrobial Resistance Website. <http://www.cdc.gov/drugresistance/community/files/html_versions/a_new_threat_to_your_health.htm>

“Evolution of Antibiotic Resistance.” Evolution Library. 2001. WGBH Educational

Foundation and Clear Blue Sky Productions, Inc. <http:www.pbs.org/wgbh/evolution/library/10/4/1_104_03.html>

Hopper, Leigh. “Increase In Staph Infections Bewilders Local Physicians.”

Houston Medical Writer 1 Nov. 2003

“Solutions to the Resistance Problem.” American Society for Microbiology. 2002

<http://www.microbeworld.org/htm/cissues/resist/resist_4.htm>