Managing Antibiotic Use and Viral Infections in Young Children

Q: Managing Antibiotic Use and Viral Infections in Young Children

Hello： There are many causes of fever in young children. <br>Please take medications as prescribed by your doctor and return for follow-up appointments to ensure safety. <br>Two different classes of antibiotics with different mechanisms of action may be prescribed. <br>If the dos

What are the administration methods for two types of antibiotics, and how should suspected adenovirus and suspected roseola be managed?

My son (1 year and 3 months) started having a runny nose and a fever around 38 degrees Celsius on June 9, which lasted all day on June 10.
If he doesn't receive antipyretic suppositories, his fever will rise to 40 degrees Celsius, but the effect of the antipyretics lasts only about 4-5 hours before the high fever returns.
There are no other obvious symptoms.
The doctors' diagnoses are as follows: 1.
Mackay Memorial Hospital: On June 9 in the afternoon, the doctor suspected "adenovirus," considering that I had conjunctivitis (acute conjunctivitis) the previous week, which might have been transmitted to my son.
They prescribed eye drops, antipyretic suppositories, and antipyretic syrup.
2.
National Taiwan University Hospital: On June 10 in the morning, the doctor suspected "otitis media" and prescribed two types of antibiotics: "Amoxicillin" and "Clarithromycin," along with nasal spray, antipyretic suppositories, and antipyretic syrup.

My urgent questions are: My son continues to have a high fever, and I suspect he might have roseola.
If it is roseola, would taking all these medications be inappropriate? However, since he has already taken antibiotics, if it is confirmed to be roseola and we stop the medication, could this lead to antibiotic resistance and worsen his health? If there is no bacterial infection in the body, will taking antibiotics still lead to antibiotic resistance? Additionally, if it is adenovirus, should he take antibiotics? When taking two types of antibiotics, is there a need to space them out? I am currently using a syringe to "mix" and administer the doses all at once, and I am concerned about potential adverse effects.
Please provide some advice.
Thank you!

GG, 40~49 year old female. Ask Date: 2013/06/12

Dr. Chen Shuzi reply Pharmacology

Hello: There are many causes of fever in young children.
Please take medications as prescribed by your doctor and return for follow-up appointments to ensure safety.
Two different classes of antibiotics with different mechanisms of action may be prescribed.
If the dosing schedule is the same, they can be taken simultaneously without the need for a time interval, but please do not "mix" them together to take "at once"! Wishing you a speedy recovery.

Reply Date: 2013/06/12

More Info

Managing antibiotic use in young children, especially in the context of viral infections, is a critical concern for parents and healthcare providers alike. Your child's situation, with persistent high fever and a potential diagnosis of either adenovirus or roseola, raises important questions about the appropriateness of antibiotic treatment and the implications of antibiotic resistance.

Firstly, it’s essential to understand that antibiotics, such as the ones prescribed to your child (安滅菌 and 萬博黴素), are effective against bacterial infections but have no effect on viral infections. Adenoviruses and roseola are viral illnesses, and antibiotics would not be beneficial in treating these conditions. The use of antibiotics in cases where there is no bacterial infection can lead to unnecessary side effects and contribute to the development of antibiotic resistance.

Antibiotic resistance occurs when bacteria evolve and become resistant to the drugs that are meant to kill them. This can happen when antibiotics are overprescribed or misused, such as taking them for viral infections. If your child is indeed suffering from a viral infection, continuing to administer antibiotics could potentially lead to resistance, making it more challenging to treat bacterial infections in the future.

Regarding your concern about the possibility of roseola, it is characterized by a sudden high fever followed by a distinctive rash once the fever subsides. If your child has roseola, the fever may be the primary symptom, and the rash typically appears after the fever resolves. In such cases, antibiotics would not be necessary, and stopping them would not lead to adverse effects related to antibiotic resistance since the primary issue is viral.

In terms of administering multiple antibiotics, it is generally advisable to follow the prescribing physician's instructions regarding timing and dosage. Mixing medications in a syringe can lead to inaccurate dosing and potential interactions, so it’s crucial to administer each medication as directed. If you have concerns about the way the medications are being given, it would be best to consult your healthcare provider for clarification.

If your child continues to have a high fever despite treatment, or if new symptoms develop, it is important to follow up with your healthcare provider. They may need to reassess the situation, potentially conduct further tests, and determine whether a different treatment approach is necessary.

In summary, while managing your child's illness, it is crucial to differentiate between viral and bacterial infections. Antibiotics should only be used when there is a confirmed bacterial infection. If your child is diagnosed with a viral infection, supportive care, such as fever management and hydration, is typically the best course of action. Always consult your healthcare provider for guidance tailored to your child's specific situation, and do not hesitate to seek a second opinion if you feel uncertain about the treatment plan.

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