The child fell ill, his temperature, snot, cough, sore throat. In this situation, parents who want to alleviate the baby's condition are usually divided into two camps - in one, antibiotic supporters, in the other, their opponents. With their doubts and questions, mothers and fathers turn to the famous children's doctor Yevgeny Komarovsky.
We have tried to collect in one article many disparate answers from this specialist so that it is easier for parents to understand when and how to give antibiotics to children.
Features:
Evgeny Olegovich talks a lot and willingly about drugs with antimicrobial action in his articles, books and video lectures. First of all, the doctor emphasizes that they exist to fight various bacteria, a number of fungi, chlamydia, etc. In almost all cases where the disease is caused by bacteria, antibiotics cannot be dispensed with. They help to recover, and in some cases save a person's life, because almost all bacterial diseases are very difficult.
The opinion of Dr. Komarovsky about antibiotics, when they can still be given, can be seen in the next video.
But in Russia there is another problem - many begin to take antibacterial drugs for influenza and ARVI, and even doctors prescribe them to their young patients.
Komarovsky emphasizes that antibiotics against viruses that cause influenza, acute respiratory viral infections, acute respiratory infections, as well as a host of other diseases, are powerless. And taking them is harmful, as the risks of complications increase and resistance to antibiotics is formed.
Komarovsky does not in the least doubt the qualifications of his colleagues who do this, and even gives a reasonable explanation for this situation. If a doctor sees that a child has flu or ARVI (this is 99% of all "cold" problems), he understands that he has nothing to treat the virus with. Because the treatment of the virus is its destruction, and only the child's immunity can do this.
A conscientious doctor, of course, must tell the parents that the child does not need any medicine, give recommendations on ventilation, drinking plenty of fluids, and wet cleaning the room. And that's all. At the same time, he is obliged to warn mom and dad that complications of a viral infection are possible, and no magic pills can somehow affect their probability, complications either will or not.
Most likely, moms and dads will say that the doctor who tells them this is incompetent and will go to another, with a request to prescribe at least something.
Thus, pediatricians advise antibiotics "just in case" more to reassure parents and in order to protect themselves from possible legal consequences if a child suddenly develops pneumonia against the background of ARVI.
Parents in this situation need to be able to say no. Komarovsky recommends learning how to object in response to such appointments, because this will make life easier for everyone - and for the doctor who actually knows that antibiotics for the virus will only harm... A mom who will know that she is on guard for the baby's health. The baby himself, who will not be stuffed with potent drugs that he does not need at all now.
Remember that antibiotics are not taken with flu, ARVI, scarlet fever, measles and chickenpox! And if the doctor says that you have tonsillitis, then the options may be different, depending on which pathogen caused it.
Dripping, injecting or drinking antibiotics
To this question, Evgeny Komarovsky replies that it is necessary to act according to the situation. Today there are many forms of release of antimicrobial drugs. But their misuse is unacceptable. Often parents buy an antibiotic in the form of a dry substance to dilute injections, dilute and give it to drink or drip into the child's ear.
This is wrong, says Komarovsky. Each drug must be used strictly as directed. The only exception is two unpleasant diagnoses - purulent otitis media and purulent conjunctivitis. With them, powder for injections is indeed allowed to be diluted with saline and dripped into the ear and eyes, respectively.
When to stop treatment
Many mothers reason like this: the child has become much better, his temperature has dropped, he has an appetite, he no longer lies in bed all day long, which means it's time to stop antibiotics so as not to stuff the little one with unnecessary chemistry. This approach is criminal, says Yevgeny Komarovsky.
The treatment regimen is prescribed for a reason. Different antibiotics can accumulate in the body in different ways, hence the timing is different - one drug is recommended to be given to the child for three days, the other - for five days. Prematurely interrupted therapy can cause a relapse of the disease, the occurrence of severe complications. In addition, bacteria not completely killed in the child's body will develop their own immunity to the antibiotic, and next time they will be resistant to it.
Is it possible to be treated with one drug for different diseases
Of course, it is possible to use the same antibiotic to treat different bacterial diseases. But Komarovsky in no case recommends treating the same disease with one drug. This increases the risk of drug allergies.
If the baby falls ill two months after recovery and taking antibiotics, the doctor should prescribe another drug for him. This will help avoid allergies and increase the chances of killing bacteria quickly. After all, some of the microorganisms could have remained in the child from the last recent illness, they have resistance to the antibiotic that was prescribed last time. A new drug is required.
Komarovsky draws the attention of adults to the fact that antibiotics are of both a narrow action and a wide spectrum of action. The former are designed for certain types and types of bacteria, the latter are active against most of the known pathogens. Since it is not always possible to accurately identify which microbe caused a particular disease, because bacteriological laboratories are far from being in every children's polyclinic, doctors try to prescribe a wide range of drugs.
Can you give your child strong antibiotics?
Strong and weak antibiotics, according to Evgeny Komarovsky, do not exist. Of course, it is much more convenient for moms and dads to assume that a drug purchased for several hundred rubles is stronger than a drug that costs several tens of rubles. Pricing policy should not be determinative. Parents just need to understand that expensive drugs are intended for difficult cases when the microbe does not respond to other drugs. Such cases, fortunately, do not happen often.
Therefore, it does not really matter which drug to give the child if necessary. It can be “Biseptol” for 80 rubles, and “Sumamed” for 600 rubles. Price does not indicate effectiveness.
Can antimicrobial agents affect immunity?
Komarovsky claims that all antibacterial agents, without exception, have no effect on immunity. The child's natural defenses are weakened not by pills and injections, but by the disease itself and the efforts that the body makes in order to defeat pathogens. In principle, antibiotics cannot either raise immunity or "bring down" it.
How to "restore" a child's body after treatment
Often parents ask how to help a child cope with dysbiosis that develops during antibiotic treatment, and it is better to prevent the appearance of diarrhea, vomiting, and abdominal pain at all.
Komarovsky believes that the connection between dysbiosis and the use of antibiotics is somewhat exaggerated. And here it was not without pharmacists, who want to make good money on the idea of compulsory restoration of intestinal flora after treatment with antibacterial agents.
A truly pathological disorder of the intestinal microflora, clinical dysbiosis that requires some kind of special treatment, according to Komarovsky, occurs quite rarely.
Typically, such consequences occur after prolonged use of broad-spectrum antibiotics, which is accompanied by an unreasonable parental attitude towards the baby's nutrition. For example, he was overfed during therapy, forced to eat, fatty foods predominated in the diet. Even in this case, Komarovsky does not advise starting a separate and rather expensive treatment with Enterofuril, giving the baby probiotics and prebiotics.
It is enough to balance the diet for recovery, and against the background of the abolition of antibiotics, the intestinal flora will quickly recover itself, it generally has the ability to quickly recover. Rehabilitation will not be long and problematic.
Komarovsky draws the parents' attention to the fact that the manufacturers of various advertised probiotics and prebiotics are silent - their effectiveness has not been clinically proven.
What to do if a child is allergic to antibiotics
There is no such concept, says Yevgeny Komarovsky. There may be an allergic reaction to some type of this group of drugs, but not all at once. If the child has had such a reaction before, you can combine antibiotics with drugs for allergies.
If in the first days after the start of treatment, the baby feels worse, you should not blame it on ineffectiveness or side effects of the drug. Komarovsky explains that this may be the result of exposure to toxins that are released during the death of microbes.
Thus, the antibiotic is working correctly, and in no case should it be canceled. And what needs to be done is to consult with your doctor. All medical specialists, even in the first year of the institute, are taught to distinguish endotoxic reactions (what was described above) from signs of drug ineffectiveness.
