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When to Use Antibiotics for Your Child 

Antibiotics are medicines used to treat infections caused by bacteria. They don’t work for illnesses caused by viruses or an allergic reaction. In fact, taking antibiotics for reasons other than a bacterial infection can cause problems. For example, your child may have side effects from the medicine. And when your child really needs an antibiotic, it may not work well.

When antibiotics won’t help your child 

Your child’s healthcare provider won’t usually prescribe an antibiotic for the following conditions. You can help by not asking for antibiotics if your child has: 

  • A cold. This type of illness is caused by a virus. Your child may have a runny nose, stuffed-up nose, sneezing, coughing, headache, mild body aches, and fever. Nasal mucus may be white, green, or yellow. A cold gets better on its own in a few days to a week.

  • The flu (influenza). This is a respiratory illness caused by a virus. The flu usually goes away on its own in a week or so. Your child may have fever, body aches, sore throat, and fatigue.

  • Bronchitis. This is an infection in the lungs most often caused by a virus. Your child may have coughing, phlegm, body aches, and a low fever. A common type of bronchitis is known as a chest cold (acute bronchitis). This often happens after a respiratory infection like a common cold. Bronchitis can take weeks to go away, but antibiotics usually don’t help.

  • Most sore throats. Sore throats are most often caused by viruses. But a sore throat may also be caused by the common bacteria streptococcus (strep throat). This is something your healthcare provider can easily test you for. It may feel scratchy or achy, and it may hurt to swallow. Your child may also have a low fever and body aches. A sore throat usually gets better in a few days.

  • Most ear infections. An ear infection may be caused by a virus or bacteria. It causes pain in the ear. A young child may pull at his or her ear. Antibiotics may not be prescribed. The infection often goes away on its own.

  • Most sinus infections (sinusitis). This kind of infection causes sinus pain and swelling, and a runny nose. In most cases, sinusitis goes away on its own, and antibiotics don’t make recovery quicker.

  • Allergic rhinitis. This is a set of symptoms caused by an allergic reaction. Your child may have sneezing, a runny nose, itchy or watery eyes, or a sore throat. Allergies are not treated with antibiotics.

  • Low fever. A mild fever that’s less than 100.4°F (38°C) most likely doesn’t need treatment with antibiotics. 

When antibiotics can help your child 

Antibiotics can be used to treat:                                                   

  • Strep throat. This is a throat infection caused by a certain type of bacteria. Symptoms of strep throat include a sore throat, white patches on the tonsils, red spots on the roof of the mouth, fever, body aches, and nausea and vomiting. Strep throat needs to first be confirmed with a test called a throat culture.

  • Urinary tract infection (UTI). This is a bacterial infection of the bladder and the tube that takes urine out of the body. It can cause burning pain and urine that smells funny or is cloudy or tinted with blood. UTIs are very common. Antibiotics usually help treat these infections.

  • Some ear infections. In some cases, your child’s healthcare provider may prescribe antibiotics for an ear infection. Your child may need a test to show what’s causing the ear infection.

  • Some sinus infections. In some cases, your child’s healthcare provider may prescribe antibiotics. He or she may first need to make sure your child’s symptoms aren’t caused by a virus, fungus, allergies, or air pollutants such as smoke. 

Helping your child feel better 

If your child’s infection can’t be treated with antibiotics, you can take other steps to help him or her feel better. Try the remedies below. In general:                                               

  • Let your child rest and sleep as much as needed.

  • Make sure your child drinks water and other clear fluids.

  • Keep your child away from smoke.

  • Use over-the-counter medicine such as acetaminophen to ease pain or fever, as directed by your child’s healthcare provider. 

To treat sinus pain or nasal congestion: 

  • Put a warm, moist washcloth on your child’s nose and forehead.

  • Use a nasal spray with medicine or saline, as directed by your child’s healthcare provider.

  • Have your child breathe in steam from a hot shower.

  • Use a humidifier or cool mist vaporizer in your child’s room.

  • Remove nasal congestion with a rubber suction bulb, if your child is young. 

To quiet a cough: 

  • Use a humidifier or cool mist vaporizer in your child’s room.

  • Have your child breathe in steam from a hot shower.

  • Give an older child cough lozenges. Don’t give lozenges to a young child.

  • Give your child honey if he or she is older than 1 year. 

To sooth a sore throat: 

  • Give your child ice chips or frozen juice pops to suck on.

  • Give an older child throat lozenges. Don’t give lozenges to a young child.

  • Use a sore throat spray on your child’s throat.

  • Use a humidifier or cool mist vaporizer in your child’s room.

  • Have your child gargle with saltwater.

  • Have your child drink warm liquids. 

To ease ear pain: 

  • Hold a warm, moist washcloth on your child’s ear for 10 minutes at a time. 

When to call your child's healthcare provider 

Call your child’s healthcare provider if your child is younger than 3 months old and has a fever. Also contact the healthcare provider if your child has any of these: 

  • Symptoms that get worse

  • Symptoms that last more than 10 days

  • Trouble breathing

  • No interest in eating

  • Trouble swallowing

  • Blood or pus from ears or in saliva or phlegm

  • Fever (see Fever and children, below)

  • Signs of dehydration, such as dry diapers, no tears, dry mouth, or weakness

  • Excess drooling in a young child

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

Below are guidelines to know if your child has a fever. Your child’s healthcare provider may give you different numbers for your child.

A baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

A child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

Online Medical Reviewer: Donna Freeborn PhD CNM FNP
Online Medical Reviewer: Heather Trevino
Online Medical Reviewer: Liora C Adler MD
Date Last Reviewed: 12/1/2019
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