As parents and caregivers, we want to do everything in our power to protect and take care of our children, particularly when they are sick. When our child has a cough, a fever or an earache, we often dash to the pediatrician and expect to leave with a prescription for antibiotics. But is that always the answer?

Antibiotics Attack Bacteria…

Antibiotics are powerful medicines that attack bacteria and kill it or keep it from growing. Antibiotics only work on infections caused by bacteria. Some infections caused by bacteria are whooping cough, strep throat and urinary tract infections.

Antibiotics do not work on infections caused by viruses. Yet, many parents often demand an antibiotic prescription for an illness caused by a virus.

“Well-meaning parents want their children to feel better quickly and think that an antibiotic is an easy solution,” says Dr. Theresa Willis, a board certified pediatrician in Austin. “Unfortunately, an antibiotic like Amoxicillin works by attacking bacterial cell walls. Because viruses don’t have cell walls, the antibiotic cannot kill the virus.”

… But Not Viruses

When deciding if an antibiotic is needed, your pediatrician evaluates whether the illness is caused by a virus or a bacteria. Common illnesses caused by viruses include:


If your child has a runny nose, cough and congestion, an antibiotic will not help. Colds are caused by viruses. To help your child be more comfortable, Dr. Willis suggests the following:

  • Saline nasal spray to help keep the nasal passages moist and clear
  • Extra fluids to drink
  • Tylenol or ibuprofen for fever and aches
  • Using a humidifier at night


Antibiotics are not effective against the flu because it is a viral infection. Antiviral medicines, such as Tamiflu, are available. These medicines help make flu symptoms milder and shorten the length of the illness. However, antiviral medicines must be started within the first two days of the flu to be effective.

Most sore throats

About 80 percent of sore throats are caused by viruses, not bacteria. If the pediatrician suspects a certain bacteria, she may order a test for “strep throat.” If the test comes back positive, antibiotics will be prescribed.


The same viruses that cause colds and flu can lead to a cough. Even though some coughs can last up to three weeks, antibiotics won’t help if the cause is a virus. Dr. Willis recommends contacting your pediatrician if your child is having trouble breathing or has fever over 102° along with the cough. Also get medical care for a child who is coughing so severely that he is vomiting or if the child is unable to eat or drink because of the cough.

Many Sinus Infections

When your child has a cold, he may have yellow or green mucus from his nose. This may last for as long as 10 days without cause for concern. In most cases, sinus infections are caused by allergies or viruses. If your child has a fever higher than 102 degrees for three or four days in addition to the mucus, or if the mucus lasts for more than 10 days, the child may need an antibiotic.

Many Ear Infections

Over 50 percent of all ear infections get well without antibiotics. If your child does not have a high fever or severe pain, your pediatrician may recommend waiting to see if the child gets better. Over-the-counter pain medicines or ear drops may be recommended to help ease the pain. If your child’s fever or pain get worse, he may need an antibiotic.

Why It’s Important

According to the Centers for Disease Control and Prevention, over half of antibiotics prescribed in the U.S. are inappropriate. Most of these unneeded prescriptions are for patients who have respiratory infections caused by viruses.

Overuse of antibiotics is a serious public health problem. Many types of bacteria are becoming resistant to commonly used antibiotics. Each year these antibiotic-resistant “superbugs” cause over two million illnesses and 23,000 deaths. As antibiotic resistance gets worse, there may not be antibiotics available to fight routine infections.

How to Use Antibiotics Wisely

  • Don’t give your child antibiotics for viral infections.
  • Never pressure your pediatrician to prescribe an antibiotic.
  • When your child is prescribed an antibiotic, give it exactly as directed and until the medicine is gone.
  • Never save leftover antibiotics or give antibiotics prescribed for someone else to your child.
  • Safely discard leftover antibiotics. See “How to Dispose of Unused Medicines” on the FDA website at

Brenda Schoolfield is a freelance medical writer in Austin.

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