Nearly every parent can recount the experience: their child is unwell, awake late at night with a sore throat, fever, maybe a persistent cough, or any combination of symptoms. No one is sleeping well, and they’ve exhausted their over-the-counter remedies.

When you make a sick visit appointment for symptoms like those listed, it’s understandable to hope for quick relief in the form of a prescription. Antibiotics are a wonderful treatment for bacterial illness or infection, but they’re ineffective against viruses and can actually cause more problems if used incorrectly. While your physician will ultimately determine treatment for illness, below are some general guidelines for antibiotic treatment.

Viruses are not cured with antibiotics. If you’re ever unsure if an illness is viral or bacterial, it’s perfectly acceptable to ask. Examples of prevalent viruses include flu, Covid-19, and common cold. Pneumonia can be viral or bacterial. Strep throat describes an infection with streptococcal bacteria; most sore throats, however, are a symptom of viral illness.

Antibiotics should not be prescribed without confirming the presence of bacteria, if possible. This is why your physician will typically request a test or culture of areas where bacterial infection is suspected. Ear and sinus infections are more likely to be confirmed by sight and treated appropriately.

If you or a family member have ever received a prescription such as Tamiflu, note that it is an antiviral and not an antibiotic. Antiviral drugs exist for certain viral illnesses, and they are usually most effective when the virus is detected early. Usually, the best treatment for viral illness is rest, fluids, and OTC symptom relief medication for fever or discomfort such as Tylenol (acetaminophen) or Advil (ibuprofen). That said…

Viruses can lead to bacterial illness. When a person’s immune system is compromised, their body becomes vulnerable to further infections. Influenza can trigger viral or bacterial pneumonia; colds can lead to ear infections. In these cases, antibiotics may be prescribed to treat the complications. If this occurs, rest assured that your doctor did not prolong or worsen your child’s illness by not prescribing antibiotics immediately. In fact…

Antibiotics can cause more problems if used prematurely or inappropriately. There are many types of antibiotics, each designed to eradicate specific harmful bacteria. The body also uses helpful bacteria to function normally.

“Using antibiotics without clear physician guidance can eradicate good bacteria, not treat the original problem at all, or make bacteria more resistant and therefore harder to treat. This is why physicians want to see patients in person before giving prescriptions: so they can treat illness the right way at the right time. Speaking of using medications appropriately…

Use all medications, including antibiotics, as directed. If your pediatrician says to administer an antibiotic for 10 days, but the child’s symptoms “clear up” after five days, finish the course of treatment anyway. Even if a patient is feeling much better, bacteria may persist in the body. Not finishing treatment can cause infection to recur, possibly with more antibiotic-resistant bacteria. Medication should also be stored and administered as directed. Some antibiotics must be refrigerated and/or given with food.  

Antibiotics are usually given with clear directions and amounts so there is none left over. If you do have leftover antibiotic, it should be disposed of safely. Do NOT give a person leftover antibiotic from previous illness or medication that was prescribed for someone else.

If anything should happen to a prescription medication, such as a spill or forgetting it when you go out of town, call your prescriber’s office for further guidance rather than skipping doses or using alternate medication. Accidents happen, and your physician can make a judgment call on refilling missing doses. Which reminds us…

Communicate with your pediatrician. When kids are seen for illness, their physician will always encourage parents to call if symptoms get worse, don’t resolve, or other concerns arise. This is sincere advice, whether the illness is viral or bacterial, medicated or not. Your pediatrician wants to know if a patient is not getting better. This includes poor reactions to any medication, such as upset stomach or new symptoms.

Some individuals are intolerant or allergic to medication, including certain antibiotics. If a child in your care shows signs of allergic reaction, including but not limited to coughing, wheezing, shortness of breath, itching, sneezing, runny nose, hives, watery eyes, or swelling, seek emergency treatment right away. If you know or suspect a child in your care has ingested too much of a medication, whether prescribed to them or not, contact Poison Control at 800-222-1222 and/or seek emergency treatment.