Every person encounters infectious organisms throughout the day in the air, in soil and water, in foods, and on surfaces everywhere. Fortunately, your child’s immune system is capable of resisting most of these organisms, keeping her healthy. When these organisms become a problem and cause an infection, your pediatrician has a number of medicines that can help your child get better.
Antibacterials are the prescription drugs with which parents are probably most familiar. Nearly every parent has had the experience of giving their child a course of antibacterials for an ear infection or strep throat. Most can name some of the most common antibacterials—penicillin, amoxicillin, tetracycline—that have helped their youngster fight off bacterial infections. Although your child has probably been given antibacterials more often than other types of infection-fighting prescription medicines, drugs are also available to fight certain childhood diseases caused by
Viruses
Fungi (yeasts and molds)
Parasites
Remember, as important as antibacterials are, they are useful only against infections caused by bacteria. For illnesses caused by other kinds of germs, antibacterials simply will not help your child get better. They can actually add risks because of the possible side effects that all medicines have. At the same time, inappropriately used medicines can contribute to the growing problem of antibiotic resistance.
Antiviral Medicines
Every child gets a viral illness from time to time. Many viral infections affect the respiratory tract, which includes the nose, throat, and breathing passages where they can cause the common cold, the flu, a sore throat, and sinusitis. Viruses also can cause more serious illnesses such as acquired immunodeficiency syndrome (AIDS), hepatitis, and rabies. Because immunizations are available to protect your child against some viral infections (eg, chickenpox, polio), make sure she is fully protected by all the vaccines recommended by the American Academy of Pediatrics.
Antiviral drugs are relatively recent developments, but an increasing number of these virus-fighting drugs are now available. They are made to prevent infection or shorten the duration of infections by preventing the virus from spreading, although they may not kill viruses that already exist. These medicines aren’t appropriate for all viral infections—if your child has the common cold, for instance, simply let it run its course. Your pediatrician will be able to tell you when prescription antiviral drugs may be needed.
Unlike broad-spectrum antibiotics, which are often useful against a wide range of bacterial organisms, antiviral medicines tend to be more specific and attack particular viruses. Here are a few examples of antiviral drugs sometimes prescribed for children.
Acyclovir is a medicine that can be used to treat chickenpox, as well as the symptoms associated with herpes infections that may affect the skin, eyes, mouth, genitals, or brain. Acyclovir can ease the discomfort and speed up the healing of herpes sores, but it will not completely kill the virus. The herpes simplex virus will stay dormant in the body and can cause symptoms again in the future.
Amantadine is among several antiviral medications that can be used to treat and prevent the flu. These medicines are most useful when started soon after your child’s flu symptoms begin. In general, the medicine should be started within the first 2 days of the illness. Amantadine is only effective in treating one type of flu virus, influenza A.
Ribavirin and interferon are antiviral drugs sometimes prescribed for adults who develop chronic hepatitis. Their use in children has been limited.
Other medicines, called antiretroviral drugs, are used to combat infections caused by a particular type of virus called a retrovirus. The most widely known retrovirus, human immunodeficiency virus (HIV), is responsible for AIDS.
Keep in mind that even though viral illnesses should not be treated with antibacterials, bacterial infections sometimes occur as a secondary complication of a viral disease. In those cases, antibacterials can be used to treat the bacterial infection.
Antifungal Medicines
Fungal infections are caused by microscopic plants whose spores become airborne and are breathed in by children. They can also enter the body through a cut in the skin. When these spores are inhaled, they may settle in the lungs and begin to multiply and form clusters. Eventually they make their way into the bloodstream and travel throughout the body. Like many infectious organisms, they can cause serious illnesses in children whose immune systems are already weakened by another disease such as cancer or AIDS.
You’re probably most familiar with fungi such as mushrooms, yeast, mold, and mildew. Some fungi can live in the body and never cause any sickness. But others cause diseases, including common infections such as ringworm of the skin, hair, and nails; athlete’s foot; jock itch; and thrush or yeast infections (candidiasis).
Many drugs can fight these fungal infections. They’re often available in a topical form that can be applied directly on the skin. Some are over-the-counter medicines, while others must be prescribed by your doctor.
For serious fungal infections, pediatricians may select a medication called amphotericin B or newer antifungal drugs called azoles. Two of the most widely used azoles are fluconazole and itraconazole. Some prescription antifungal drugs are not licensed for use in children, largely because little research has been done with youngsters. These medicines should be used with care and your pediatrician’s guidance because they may have serious side effects.
Although over-the-counter antifungal products are considered safe when used according to the instructions on the label, it’s always a good idea to talk with your pediatrician before treating your child with these medicines.
Antiparasitic Medicines
Parasites can cause childhood infections. In some parts of the world, they are a common cause of illness and death. In the Western world, adults and children often contract parasitic diseases while traveling to tropical regions of the world where these illnesses are most prevalent, such as rural Central and South America, Asia, and Africa.
Some parasites are so tiny that they can’t be seen except under the microscope, while others are large enough to be viewed very easily with the naked eye. Most live in food, water, and soil. When they’re transmitted to your child, often when she consumes contaminated food or water, her immune system can successfully fight off many of them. Other parasites, however, can cause potentially serious infections.
The parasitic infection best known to parents is pinworms, but others include malaria, tapeworms, hookworms, and trichinosis. Some antibacterials also work against parasites. Metronidazole can block the reproduction cycle of some parasites as well as some bacteria. There are some antiparasitic drugs that are only available directly from the Centers for Disease Control and Prevention (CDC), and your doctor must specifically request them from the CDC.
Resistance is increasingly becoming a problem with some antiparasitic medicines. For example, some drugs used to treat malaria are not as effective as they were in the past because of resistance. As a result, new antimalaria drugs are now in development and being studied in clinical trials.
There are common myths that certain parasitic diseases are caused by poor hygiene and can only be prevented or treated by improving personal cleanliness. These are only myths. Medicines are available to treat parasitic infections. Your child’s cleanliness is not going to cure the infection. However, as with many other infectious diseases, including some parasitic illnesses, hand washing is important and a good way to avoid germs that can make your child sick.