Antibiotic Use in Infants: Risks and Alternatives

Regarding the use of antibiotics in infants?

Hello, my baby is now over eight months old and weighs about 9 kg.
He often has thick nasal mucus that causes nasal congestion, preventing it from draining on its own.
When we take him to the clinic, the doctor usually prescribes Noscapine 2.5, Bricanyl 1, and Bismuth 4.5.
However, if there is no improvement after three days, the doctor adds the antibiotic ZINACEF.
After starting this medication, my baby's bowel movements become somewhat abnormal, but still within the normal range.
I would like to ask the following questions:
1.
Does the use of this antibiotic for 2 to 3 weeks have any impact on my baby's cognitive development?
2.
Is the use of this antibiotic necessary, or are there other non-antibiotic medications that can be used?
3.
My baby may have a hereditary nasal allergy, so if we stop using the antibiotic, could he experience nasal congestion and thick mucus again due to weather changes? Is it inevitable that he will need to take antibiotics?
4.
Currently, I am giving my baby 2.5 cc of a bronchodilator twice a day.
Is this medication effective in preventing nasal allergies?
Thank you for taking the time to respond.

Qì'é māmā, 20~29 year old female. Ask Date: 2008/01/07

Dr. Hou Fangmin reply Pharmacology

Hello, regarding the medication Noscapine that your baby is using, it is a cough suppressant, and it is important to pay attention to the dosage when used in infants.
Bricanyl is a bronchodilator that helps prevent mucus or nasal discharge from entering the airways and causing obstruction.
Bismuth is a gastric mucosal protectant and can be used as a stomach medication.
ZINACEF, which is a cephalosporin antibiotic, can treat infections such as pneumonia.

In response to your first question, although ZINACEF (cefuroxime) can cross the blood-brain barrier, it can be used for infections in newborns.
The dosage is approximately 50-100 mg/kg/day, which you can use to estimate whether the physician has exceeded the dosage (your baby's daily dosage is approximately 450mg-900mg).

For your second question, long-term use of antibiotics can easily lead to bacterial resistance, which may result in severe infections.
It is advisable to have the physician evaluate whether it is necessary to continue using antibiotics.
Once antibiotics are started, it is important to complete the entire course of treatment and not to stop suddenly to avoid increasing bacterial resistance.
Regarding your third and fourth questions, nasal allergies are not necessarily caused by infections, and antibiotics may not be the only treatment option.
Some bronchodilators, such as the one mentioned in your fourth question (Asthma Relief Liquid), can also help alleviate some allergy symptoms.
If you have any other questions, feel free to ask.

Reply Date: 2008/01/07

More Info

When it comes to the use of antibiotics in infants, it is essential to understand both the potential risks and the appropriate alternatives. Your concerns about your eight-month-old baby, who has been prescribed antibiotics like ZINACEF for persistent nasal congestion and thick mucus, are valid and warrant careful consideration.

1. Impact on Cognitive Development: Research indicates that while antibiotics can disrupt the gut microbiome, which plays a crucial role in overall health, the direct impact on cognitive development in infants is not well-established. However, prolonged or unnecessary use of antibiotics can lead to antibiotic resistance and may affect the infant's immune system. It is crucial to use antibiotics judiciously and only when there is a confirmed bacterial infection, as opposed to viral infections, which are more common in infants and do not require antibiotic treatment.

2. Necessity of Antibiotics: The decision to prescribe antibiotics should be based on a thorough clinical evaluation. If your baby's symptoms are due to a viral infection, antibiotics would not be effective. In cases of bacterial infections, such as bacterial sinusitis, antibiotics may be warranted. However, if your baby has been on antibiotics for 2-3 weeks without significant improvement, it may be worth discussing with your pediatrician whether a different approach or further evaluation is needed. There are non-antibiotic treatments available, such as saline nasal drops, humidifiers, and other supportive care measures that can help alleviate nasal congestion.

3. Genetic Predisposition to Allergies: If there is a family history of allergies, your baby may be more susceptible to allergic rhinitis, which can cause nasal congestion and thick mucus. In such cases, it is essential to identify and manage potential allergens rather than relying solely on antibiotics. If your baby experiences recurrent nasal congestion due to allergies, your pediatrician may recommend antihistamines or other allergy management strategies instead of repeated courses of antibiotics.

4. Use of Bronchodilators: The medication you mentioned, which your baby is currently taking, may help alleviate symptoms of bronchospasm or wheezing. However, it is essential to ensure that any medication prescribed is appropriate for your baby's age and condition. While bronchodilators can be effective in managing respiratory symptoms, they should be used under the guidance of a healthcare professional, especially in infants.

In summary, while antibiotics can be necessary in certain situations, their overuse can lead to significant health risks, including antibiotic resistance and potential impacts on the gut microbiome. It is crucial to work closely with your pediatrician to determine the most appropriate treatment for your baby's symptoms. If you have concerns about the necessity of antibiotics or the potential for allergies, consider seeking a second opinion or consulting a pediatric allergist for further evaluation and management options. Always prioritize open communication with your healthcare provider to ensure the best care for your child.

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