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According to an analysis by the Centers for Disease Control and Prevention (CDC) published in August in the Journal of the Pediatric Infectious Diseases Society, nearly 70,000 children end up in emergency rooms every year after having had reactions. antibiotics.
Most of these incidents were due to an allergy and it was mostly mild (such as a rash), but some were more serious (such as anaphylaxis, a serious condition). life threatening often observed when allergies to peanut or bee sting). Children under 2 were the largest part of the emergency visits.
About 74 million prescriptions of antibiotics are distributed to children each year, the study notes, and previous research has shown that at least a third of these prescriptions for pediatric antibiotics are useless.
Excessive prescription of these drugs may contribute to antibiotic resistance, as weaker bacteria are systematically killed and "superbugs" that can not be treated with antibiotics proliferate.
"In many cases, these are lifesaving drugs whose benefits far outweigh the risks," says pediatrician Katherine Fleming-Dutra, co-author of the study and assistant director of the surveillance office. CDC antibiotics. "But it's also important to recognize these risks, both in terms of long-term antibiotic resistance and acute short-term events."
Previous research had estimated that up to 10% of all antibiotic prescriptions prescribed to children caused an allergic reaction. Here's what parents need to know about the new study and the topics to discuss with your pediatrician.
What the study found
Using national data on emergency visits between 2011 and 2015, CDC researchers estimated that 69,464 annual visits were made by children under the age of 19 who had "adverse events" related to antibiotics. .
The vast majority of these events – 86.1% – involved a kind of allergic reaction. Fleming-Dutra notes that there is a wide spectrum of what could constitute an allergic reaction, from anaphylaxis to mild rashes and gastrointestinal problems. 77% of all problems identified in the study were considered "benign allergic events".
Adverse effects due to antibiotics, which were not allergic reactions, most often involved problems with diarrhea and diaper rash in young children and gastrointestinal problems, such as nausea, vomiting, diarrhea and abdominal pain in older children. Headaches and yeast infections were less common reactions and some antibiotics produced rare side effects such as light sensitivity.
The researchers observed the greatest number of adverse effects in children under 2 years old. One in 400 children, 2 years old or younger, goes to the emergency department each year with an antibiotic reaction. The older the child, the less likely he was to have a negative reaction to antibiotics.
Pediatrician Mark Sawyer, member of the Infectious Disease Committee of the American Pediatric Association, who did not participate in the study, says it is not surprising that there are more side effects in younger children.
Sawyer says younger children are more prone to infections and therefore more likely to be prescribed antibiotics. They are also more likely to have allergic reactions. And new parents may tend to be anxious, leading young children to emergencies for more minor symptoms, Sawyer adds.
Fleming-Dutra says that ultimately, your pediatrician should decide which drug will be prescribed to your child – or not at all. But this study can be a good "topic of conversation between parents and doctors," she says, sparking "a more informed discussion about the potential risks and benefits of antibiotics."
What parents should know
Sawyer said discussions about the pros and cons of antibiotics have increased in recent years and fewer doctors are prescribing them unnecessarily for viral infections, for example.
And the growing body of research on the risk of antibiotic-related side effects and the harms of over-consumption – the CDC published a similar study on adverse effects in 2016 – may help shift the conversation between parents and doctors .
"I think nervous parents can sometimes push pediatricians to look for antibiotics, because they are considered a miracle solution to all kinds of diseases," he says. "Studies like this can help people understand that they are not always the answer."
Here are some things to know the next time you take your child to the pediatrician – either with a condition that may require antibiotics or with the symptoms of an adverse drug reaction.
• Coughs and runny noses usually do not require antibiotics. These drugs can not do anything against colds and other viruses. If your child's symptoms are severe, you can definitely take them to the doctor. Just be aware that antibiotics will probably not be the answer.
• Sore throats can not be treated with antibiotics unless your child has streptococcus. Parents sometimes think that the sore throat of the child is caused by the streptococcus bacteria (streptococcus) and that it can therefore be treated with antibiotics. However, in about 80% of cases, sore throats are of viral origin. Your pediatrician should be tested for streptococcus before prescribing antibiotics.
• Antibiotics are not effective for most ear infections. According to Dr. Sawyer, research has shown that antibiotics do not make sense for most ear infections, especially in older children. To treat the pain caused by ear infection, it is more effective to give your child pain killers such as ibuprofen (Advil or generic) or acetaminophen (Tylenol or generic).
• Mild adverse reactions to antibiotics are common. It is not uncommon for children to experience mild rash, nausea, diarrhea and even vomiting in response to antibiotics. Sawyer says that these symptoms do not necessarily lead to an allergy; often, pediatricians recommend that your child finish antibiotic treatment even if he has these reactions. And fortunately, these side effects due to antibiotics often become less serious or disappear with age.
• There are obvious signs of a dangerous allergy to antibiotics. Although mild reactions do not pose a big problem, you should take your child to the hospital immediately if, after taking his first antibiotic – or after taking a new type – he has trouble breathing; their throat is swollen or tight; their pulse is weak; they have severe hives; or they have a crisis or lose consciousness.
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