The winter season is upon us, and for most parents this translates into the dreaded cold and flu period that their children face every year.
It’s not just your imagination – children and young adolescents are more susceptible than adults to infections. Their immune systems are still immature, which greatly increases their risk of contracting infectious diseases. Small children, especially when they attend daycare, can get 8 -10 cold infections per year before their second birthday. (1, 2)
Tending a sick child with high fever, a runny nose, sore throat, and a lingering cough is worrisome and stressful. In an effort to relieve their children’s aches, parents are often inclined to demand antibiotics from their doctor. Anxious to keep their patients happy, doctors often oblige. (3, 4)
This is usually the wrong course of action. Prescribing antibiotics for conditions like the common cold, acute bronchitis, the flu, and diarrhea is often unnecessary and a waste of time. Even worse, it could have serious consequences like weakened immunity, poor digestion, and potentially a lifetime of health problems.(5)
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Antibiotics are Over-Prescribed To Children
Antibiotics are medicinal compounds capable of targeting and killing bacteria. Since the discovery of penicillin by Alexander Fleming in 1928, they have saved millions of lives. (6)
However, infections can have multiple causes: most of the time, they are caused by viruses and more rarely by bacteria. Antibiotics are ineffective against viral and fungal infections. And even when bacteria are behind the infection, many times the illness resolves by itself thanks to the body’s own defenses.
The prescription of antibiotics to children for the treatment of common and self-limiting viral and bacterial diseases is far too common. It has contributed to widespread bacterial resistance and can cause unnecessary side effects, like Candida overgrowth and other gut imbalances, in both the short and long term. (7, 8, 9)
The 6 Downsides of Taking Antibiotics
1. Weakened immunity and recurrent infections
Your immune system is adaptive. It functions by interacting with the bacteria or virus when you are infected, and by producing specific antibodies against the foreign proteins (antigens) of the infecting microbe.
When you are re-infected by the same microbe, your immune system should be capable, with the help of the previously produced antibodies, of rapidly recognizing those foreign antigens and attacking the infecting agent. (10)
This is how you build up immunity to infections, but antibiotics can prevent this process from happening.
According to recent research, prescribing antibiotics early in the course of a bacterial infection can lead to a poor antibody production by the immune system. Your body does not have enough time to properly interact with the pathogenic bacteria and produce the necessary antibody. This can result in recurrent infections by the same bacteria. (11)
2. A Disrupted gut microbiome
More than 100,000,000,000,000 beneficial microorganisms live in the human gut – this is your gut microbiome. These microorganisms include many species of beneficial bacteria that, among other things, help to regulate your immunity and protect your digestive tract against pathogens. (12)
Antibiotics target the harmful bacteria, but they can also eradicate the beneficial bacteria that live in your gut. This can lead to dysbiosis, a disturbance in the balance between the different bacteria and fungi. Pathogenic bacteria, or fungi like Candida albicans, then have the opportunity to grow.
When the gut microbiome is disrupted, important metabolic processes are altered, possibly leading to long term diseases like inflammatory bowel disease (IBD) or Crohn’s disease (CD).
It also increases your susceptibility to intestinal infections, making it easier to develop an illness when you contract a harmful virus or bacteria. (13)
Children are born relatively sterile. They acquire their microbes when they first interact with their environment and the people around them (including their mother during birth). In the first 3 years of life, their gut microbiome is still unstable and in constant development.
Exposing your child to antibiotics early in life can have long lasting negative effects on the bacterial community in the gut and on the shaping of the child’s immune system. (14)
3. Adverse drug events (ADEs): rash, diarrhea, and vomiting
In a study from 2016, researchers showed that 42% of children exposed to antibiotics over the course of 6 years experienced side effects, known as adverse drug events or ADEs. The most common ADEs were rashes, diarrhea, and vomiting. (15)
Many children can experience bouts of diarrhea shortly or even weeks after an antibiotic treatment, the reason being most probably the lost balance between all the beneficial microorganisms living in the intestines. (16)
Clinicians usually suggest discontinuing the antibiotic treatment and prescribe probiotics to help stop the diarrhea and restore the digestive flora. (17)
4. Severe allergic reactions
Up to 10% of children and adults can present allergic symptoms to antibiotics. These allergies can manifest in different forms and are diagnosed either immediately after the administration of the antibiotic or later during the course of treatment.
The allergic reactions can range from a simple rash and nasal congestion to the more dangerous anaphylactic shock, which if not rapidly treated may cause death. (18)
5. Childhood obesity
There is clear evidence that a disturbed gut flora, such as that created by the use of antibiotics, can lead to weight gain. Recently, children exposed to antibiotics in early life have been shown to have an increased risk for childhood obesity. (19, 20)
Animal studies have also demonstrated that the use of antibiotics can increase body fat. In fact, antibiotics are widely used in livestock industries to ‘fatten up’ animals. (21)
While the mechanisms behind the connection between obesity and antibiotics are still not completely understood, researchers have suggested a link between the disrupted gut microbiome caused by antibiotics and a change in metabolism, which then leads to obesity. (22)
6. Widespread bacterial antibiotic resistance
One of the most harmful effects of the misuse and over-prescription of antibiotics, especially in children, is the widespread antibiotic resistance now seen among bacteria.
Bacteria are capable of acquiring resistance to the mechanisms of action of an antibiotic. In fact, when bacteria are exposed to a specific antibiotic for longer periods, they become sensitive to the antibiotic, then mutate and adapt to it, thus surviving the antibiotic treatment. These resistant bacterial strains then further disseminate in the population, globalizing the problem. (23)
In the last decades, antibiotic resistance has turned into a real public health burden. Current antibiotics are becoming inefficient for the treatment of common bacterial infections like salmonellosis and pneumonia, prolonging hospital stays and raising medical costs. (24)
Moreover, the threat of new bacterial diseases emerging and to which no effective treatment exists is real. (25)
How Can You Minimize The Use Of Antibiotics?
Minimizing the use of antibiotics is critically important, both on a personal level and from a wider societal perspective. By reducing the use of antibiotics in your family, you can prevent long-term digestive issues and weakened immunity. By doing so, you can also prevent the dangerous spread of antibiotic resistance.
Here are some simple, yet effective measures that you can adopt.
1. Use antibiotics only when necessary
Most infections contracted by children, such as the flu, acute bronchitis, or the common cold, are viral and can resolve by themselves. Only very rarely are these diseases complicated by secondary bacterial infections like bronchitis, sinus infections, or strep throat.
In these cases of viral infections, antibiotics are unnecessary and ineffective. Their prescription can possibly cause adverse effects and undermine the body’s natural defenses. (26)
2. Take narrow-spectrum rather than broad-spectrum antibiotics
When a child is diagnosed with a bacterial infection such as conjunctivitis, acute middle ear infection, or streptococcal pharyngitis (strep throat), the best way forward is to identify the specific bacteria that is behind the infection. The treating physician can then prescribe narrow-spectrum rather than broad-spectrum antibiotics.
Narrow-spectrum antibiotics are active against specific bacteria and cause much less harm to the immune system and gut microbiome of the sick child. (27)
On the other hand, using broad-spectrum antibiotics can lead to bacterial resistance and recurrent infections. (28)
3. Use the right antibiotic dosage and treatment duration
If antibiotics are necessary, physicians should prescribe the right dose of antibiotic and for the optimal duration to effectively treat the bacterial infection. This would limit antimicrobial resistance and future reinfections. (29)
4. Prevent infections from happening
Lastly, adopting a healthy and active lifestyle is the best way to fight and prevent infections, and therefore reduce the use of antibiotics.
With so many sedentary activities for kids these days, like watching TV or playing Xbox, physical activity sometimes gets forgotten. However, many studies have demonstrated the positive effects that moderate and regular physical exercise has on the immune system. (30)
A balanced, healthy diet is also important. Too many kids are raised on sugary cereals, processed foods, and very few vegetables. Switching to a nutrient-rich, low-sugar diet can improve immunity and reduce the chance of infection. In fact, malnutrition is directly related to an increase in the incidence of infections. (31)
Supplements can help to build immunity too. A study in 2018 showed that supplementing children’s and infant’s diets with probiotics was associated with a reduced risk of infection and therefore reduced use of antibiotics. (32)
What If Your Child Has To Take Antibiotics?
If you have no choice but to take antibiotics, probiotics can help in this case too. Probiotics reduce the side effects of antibiotic use, like diarrhea and bloating, and they help to restore beneficial microorganisms to your gut.
When you look for a probiotic, find one that contains a high CFU count and lots of strains of bacteria, and that will deliver those bacteria past stomach acid and to your gut.
Just remember to take the probiotics a few hours apart from the antibiotics. This ensures that the beneficial bacteria in the supplements are not immediately destroyed. If your children are experiencing side effects from antibiotics, the probiotics will soon help them feel more comfortable, and you can rest assured that you’re doing all you can to protect their long term health.
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