Need For Antibiotics In Babies: Uses And Side Effects

Antibiotics, often known as antibacterials, are used to treat bacterial infections. They can either inhibit the bacteria from growing (bacteriostatic) or kill them (bactericidal). Antibiotics for babies are available in liquid preparations (suspensions and syrups). Otherwise, they are administered orally as capsules or tablets or delivered via intramuscular injections or intravenous (IV) methods.

Broad-spectrum antibiotics can treat a wide range of microbial infections, and narrow-spectrum antibiotics are effective against a few specific ones. Depending on the illness, single or combination antibiotic therapy is prescribed. Hospitalization and intravenous antibiotics are frequently required for severe bacterial infections. Topical antibiotics in creams, lotions, or ointments may also treat bacterial infections on the skin.

Read on to know about the use and negative effects of antibiotics in babies and ways to avoid antibiotic abuse.

Need For Antibiotics In Babies And Toddlers

Your baby or toddler receives antibiotics if they have a bacterial infection. Although certain bacteria are part of the normal microflora in the human body, some of them and other bacteria may cause infections in certain circumstances.

The following conditions usually require antibiotics (1).

• High fever due to bacterial infection requires antibiotic treatment. Doctors may also diagnose the type of bacterial infection causing fever by observing other signs and symptoms in the baby..

• Ear infections may present with symptoms such as  excessive crying, ear pulling, loss of appetite, and fever and may need treatment with an antibiotic such as amoxicillin.

• Bacterial pneumonia in babies is treated with antibiotics. Although the specific bacterium is not identified in some cases, doctors may prescribe antibiotics since pneumonia complications can be dangerous for infants.

• Whooping cough is treated with antibiotics such as azithromycin, erythromycin, or clarithromycin.

• Urinary tract infections, such as cystitis and pyelonephritis, caused by bacteria are treated with antibiotics. The bacterial UTI is usually confirmed by microscopy and urine culture.

• Sinus infections (sinusitis) due to bacteria could need antibiotic treatment since, if left untreated, it may increase the risk of complications, such as meningitis.

• Strep throat is also treated with antibiotics since the infection could increase the risk of rheumatic fever.

• E. coli infections, Group B streptococcus (GBS), and Listeria infections soon after birth may require antibiotic treatment. Babies may contract these bacteria during vaginal delivery.

Doctors may order a complete blood count and blood culture to confirm bacterial infections before prescribing antibiotics. Antibiotics and their administration route are decided based on the type of infection and baby’s age, weight, and health status. 

Ways To Avoid Overuse Of Antibiotics

Inappropriate and unnecessary use of antibiotics may result in antibiotic resistance and other problems. The following tips may help in safe antibiotic use in babies (2).

• Always seek a prescription of antibiotics from a pediatrician
• Never use antibiotics for viral infections such as flu or cold
• Follow the recommended dose and course of treatment even though the baby gets better
• Do not share antibiotics among siblings or peers though they have similar conditions
• Do not self-medicate with antibiotics
• Seek a new prescription from the pediatrician if you run out of antibiotics

Most of the bacterial infections get better within one or two days after beginning antibiotic therapy. However, you have to complete the prescribed course of treatment. You may contact the pediatrician if there is no improvement in symptoms within two days of treatment. 

Side Effects And Long-Term Effects Of Antibiotics In Babies

Antibiotics may have side effects in some babies. It is advisable to inform the pediatrician about the baby’s history of antibiotic side effects before the prescription. Pediatricians may prescribe a different group of antibiotics that may not cause similar side effects.

Common antibiotic side effects may include the following (3).

• Allergic reactions, such as skin rashes that look like hives, may occur due to some antibiotics.

• Antibiotic-associated diarrhea is commonly caused by erythromycin and co-amoxiclav. This may occur during treatment or up to a few weeks after the treatment.

• Drug reactions may also cause skin lesions.

• Yeast infections, such as oral thrush, may occur due to change in microflora.

• Teeth staining may occur with the use of some antibiotics, such as tetracycline, minocycline, and doxycycline.

• Drug-induced fever may be seen with some intravenous (IV) antibiotics

Although they are common, most of the above-listed side effects are not life-threatening and resolve after treatment. Allergic reactions may require corticosteroids or antihistamines in some babies, and antifungals help to manage yeast infections.

Some antibiotics may cause adverse drug-related emergency room visits among babies. Adverse antibiotic side effects and long-term effects may include the following (3).

• Anaphylaxis is a life-threatening allergic reaction including breathing trouble and/or hypotension (low blood pressure) with various allergy symptoms (4).

• Musculoskeletal problems, such as tendon rupture, pain, and swollen joints, may occur with the use of ciprofloxacin (Cipro) and other fluoroquinolones (4) (5).

• Pill esophagitis is inflammation of the esophagus due to irritation of the mucosa from large antibiotic pills, such as doxycycline.

• Drug or pill-induced esophagitis is inflammation of the esophagus due to irritation of the mucosa. Swallowing certain medicines or pills is one of the reasons that may trigger the allergic reaction (6).

• Ototoxicity is seen with the use of aminoglycosides, such as gentamicin. Antibiotic-induced cochlear or vestibular damage may result in hearing loss (7).

• Stevens-Johnson syndrome is a life-threatening hypersensitivity that causes flu-like symptoms with mucosal ulcers or erosions on the nose, mouth, genitals, and eyes (8).

• Toxic epidermal necrolysis (TEN) is a severe form of Steven-Johnson syndrome causing large areas of skin to peel away.

• Red man syndrome involves itchy red rashes with angioedema and hypotension due to the use of intravenous vancomycin (9).

• Clostridium difficile diarrhea and other gastrointestinal symptoms may occur due to antibiotics (3).

• Drug-induced lupus may occur in some babies treated with certain antibiotics, such as minocycline, for a longer duration.

Not all antibiotics cause side effects and long-term effects when taken at the right dose for a given time. Always seek prescriptions for antibiotics. If you notice side effects, never hesitate to inform the doctor since they may prescribe an alternative antibiotic for the same condition.

References

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Reviewer

Dr. Neema ShresthaMD

     

Dr. Neema Shrestha is a pediatrician with a special interest in the field of neonatology. She has an overall experience of five years working in the field. Currently working in Kathmandu, Nepal, she completed her MBBS from Kasturba Medical College, Manipal in 2008, Diploma in Child Health from D.

Read full bio of Dr. Neema Shrestha