Antibiotics May Be Hazardous To KidsApr 25, 2005 | www.sunstar.com.ph
When Veronica's three-week-old son, Jeffrey, had his first cold, she asked for antibiotics. But more infections followed. And the antibiotics kept coming: amoxicillin, augmentin, zithromax, reception 17 different courses in one year.
By the time Jeffrey was 18 months old, he contracted a bacteria that was resistant to every oral antibiotic available. His only hope was an antibiotic given intravenously. The doctor told Veronica it was the last option.
Fortunately, the antibiotic worked. The mother learned her lesson. "By giving my son as many antibiotics as we did by the time he was a year old, we created a superbug," she says.
"Superbug" is how the experts called those drug-resistant bacteria. Jeffrey is a good example: "He was setup for resistant bacteria," the doctor told Veronica, "because he had taken so many antibiotics."
In an article I have written for the Asian edition of "Reader's Digest" last year, I noted: "Make no mistake: antibiotics remain our most effective weapon against disease-causing bacteria, with the power to save lives and prevent debilitating illness. But research shows that when overused or misused, these drugs actually make a person more vulnerable to attack by a superbug."
Antibiotics are medicines that either to kill bacteria or prevent its growth. As all doctors know, antibiotics are not designed or effective in viral infections such as many upper respiratory infections (URIs), bronchitis or colds.
Currently, around 60 kinds of antibiotics are available for use in infants and children, and many more are being developed. It is estimated that 30 million courses of antibiotics are prescribed for children with ear infections alone in the United States each year.
Parental pressure is the major reason pediatricians prescribe antibiotics to children who probably don't need them, according to the Boston University School of Medicine. In a survey, 96 percent of those polled had been asked by parents to prescribe antibiotics.
Forty percent said such a request had been made at least 10 times. And that, virtually everyone agrees, is not a good thing. Overuse of antibiotics has led to the evolution of germs that are resistant to standard medicines, such as penicillin. Anyone who has taken antibiotics has an increased risk of coming down with a resistant infection.
How do bacteria become drug-resistant? Antibiotic resistance results from gene action, according Dr. Ricki Lewis, an American geneticist. "Bacteria acquire genes conferring resistance in any of three ways," he explains.
"In spontaneous DNA mutation, bacterial DNA (genetic material) may mutate (change) spontaneously." Drug-resistant tuberculosis arises this way.
"In a form of microbial sex called transformation, one bacterium may take up DNA from another bacterium," Dr. Lewis says. Pencillin-resistant gonorrhea results from transformation.
Most frightening, however, is resistance acquired from a small circle of DNA called a plasmid that can flit from one type of bacterium to another.
In 1968, 12,500 people in Guatemala died in an epidemic of Shigella diarrhea. The microbe harbored a plasmid carrying resistances to four antibiotics!
On why children are more susceptible to superbugs, Dr Dominic Garcia, an infectious-disease specialist at the Gat Andres Medical Center in Manila, explains:
"Children's immune response to infection is not yet fully developed, so their ability to combat drug-resistant forms of bacteria is less than the adults."
What should parents do? In the Reader's Digest article I wrote, I have outlined four suggestions. These are:
1. Don't pressure your pediatrician to prescribe an antibiotic. Most physicians could cut back on antibiotic prescriptions anywhere from ten to 50 percent without compromising on care, according to Dr. Po-Ren Hsueh, an infection specialist and clinical microbiologist with the Departments of Laboratory Medicine and Internal Medicine at the National Taiwan University Hospital.
2. Ensure the problem is bacterial. "Parents should realize that antibiotics are only useful for bacterial infections and have no effect on viruses," explains Dr. Chong Chia Yin, the head of pediatric infectious diseases at the KK Women's and Children's Hospital in Singapore. In many instances, bacteria can be detected from throat swabs within I've minutes. When a test takes overnight, wait for the results before starting antibiotics.
3. If an antibiotic is prescribed, treatment starts with a "first choice" drug. Amoxicillin, for example, is effective against more common germs. Escalating immediately to a "big gun" antibiotic will risk altering a child's bacterial balance--making room for new germs and infections, and possibly a superbug.
"Antibiotics should only be taken on physician's prescription so that the correct and most cost-effective antibiotic class is selected with the proper dose, route and duration of treatment," points out Dr Celia Carlos, an infectious disease specialist in pediatrics at the Antimicrobial Resistance Surveillance Unit at the Research Institute for Tropical Medicine.
4. Once a course of antibiotics is begun, continue them for the full length of treatment even if symptoms abate. Any shorter course may allow the more resistant bacteria to repopulate.
"If there is an adverse reaction, see your doctor immediately instead of stopping the drug on your own," advises Dr Mun San Lam, an infectious disease consultant physician with the Mount Elizabeth Medical Center in Singapore.