If your child has a sore throat, cough or runny nose, you might expect the doctor to prescribe antibiotics. But most of the time, children actually don't need antibiotics to treat these illnesses. In fact, antibiotics can do more harm than good. Here's why:
Antibiotics do not fight viruses.
Most childhood infections are caused by viruses. Viruses can make your child feel very sick. If your child has a virus, antibiotics will not help your child feel better or keep others from getting sick.
The common cold and flu, RSV and COVID-19 are all viruses.
Most sore throats are caused by viruses, especially when there is also a runny nose or cough.
Chest colds, even when the cough thick, sticky phlegm or mucus last a long time, are most often caused by viruses. Cigarette smoke and pollution can increase a child's risk of getting one of these viruses, but bacteria are not usually the cause.
Most sinus infections (sinusitis) are caused by viruses. The symptoms are a lot of mucus in the nose and post-nasal drip. Most sinus infections will go away on their own without antibiotics. Mucus that is yellow or green does not necessarily mean your child has a bacterial infection.
Antibiotics have risks.
Side effects from antibiotics are a common reason that children go to the emergency room. Common side effects from antibiotics include:
Diarrhea or vomiting
Allergic reaction: Some allergic reactions can be serious and life-threatening.
Antibiotic resistance: When antibiotics are not use correctly or used too often, they can cause bacteria to change. That means the medicines won't work as well when they are needed. These antibiotic-resistant infections are harder to cure.
There are other ways to treat your child's symptoms.
Antibiotics kill bacteria but they do not treat symptoms of an illness, such as ear pain, fever, cough or congestion.
Fever is treated with an 'anti-pyretic' such as ibuprofen or acetaminophen. It is important to know the correct dose to give your child.
Pain, such as ear pain or throat pain, is treated with ibuprofen or acetaminophen. As always, it is important to know the correct dose to give your child.
Congestion can be helped by using a humidifier.
Cough can be helped by a spoonful of dark honey if your child is over 1 year of age.
Ask your doctor about treatments to help your child's symptoms.
When does your child need antibiotics?
There are some infections that should be treated with antibiotics. Antibiotics may be needed in these situations:
For infants younger than 3 months old, call your pediatrician for any fever above 100.4° F.
If your child has been diagnosed with strep throat, based on a rapid strep test or a throat culture. If strep is not diagnosed with a test, antibiotics should not be given. No test is needed if your child has a runny nose and cough with a sore throat. Those are symptoms of a virus.
If your child's breathing started to get better and then worse again with new fever or new symptoms. In these cases, your doctor might evaluate your child for bacterial forms of pneumonia or sinusitis.
If whooping cough (pertussis) is diagnosed.
Note: Antibiotics and cough and cold medicines have been identified by The American Academy of Pediatrics (AAP) as specific treatments that are commonly given to children but are not always necessary. The designation is part of the Choosing Wisely® campaign, an initiative of the ABIM Foundation. The full list of specific tests or treatments gives more detail as to the reasons for taking a closer look at each treatment and cites evidence related to each recommendation.
Don't hesitate to talk with your child's pediatrician if you have any questions about their health.