Doctor with prescription without antibiotics

Children with runny nose, cough, diarrhea, conjunctivitis... caused by viruses do not need antibiotics, but only treat cough symptoms by using expectorants, cough suppressants, and fever reducers when needed.

As one of the first people in Vietnam to write books about antibiotics, Associate Professor, Dr. Nguyen Tien Dung, former head of the Pediatrics Department, Bach Mai Hospital, Hanoi, believes that “antibiotics should only be used when absolutely necessary”. He is well-known for his strengths in treating respiratory diseases, asthma and antibiotics. One thing that is easy to notice in this doctor’s prescriptions is that antibiotics rarely appear.

“Prescribing antibiotics for children is much easier and more ‘relaxing’ for doctors, but it is not good for children,” Dr. Dung shared. With more than 30 years of experience working in the field of pediatrics, he realized that with pneumonia, the main weapon to save children is antibiotics. However, it also leads to another very serious and extremely dangerous consequence: antibiotic abuse.

There are many reasons for prescribing antibiotics. According to Associate Professor Dung, the first reason is because the patient's family requests antibiotics. Many people consider antibiotics a "cure-all" medicine: sore throat, fever, runny nose... they immediately think of using it. In addition, the doctor's examination time is too short, leading to an uncertain diagnosis or not having enough time to explain to the family why antibiotics are not needed.

Associate Professor, Dr. Nguyen Tien Dung, former head of Pediatrics Department, Bach Mai Hospital, Hanoi. Photo: NP

In fact, many studies around the world have concluded that if the cause of the disease is a virus, using antibiotics will not help the disease recede faster, but will also make the child tired, lose appetite, and can even lead to prolonged diarrhea, allergies...

Respiratory diseases are very common in young children, in which the main cause is viruses, accounting for about 2/3. Therefore, the doctor's job is to accurately diagnose what the disease is, whether it is an infection or not. If it is an infection, it is due to bacteria or super bacteria. For example, with the same fever, it may be due to a virus, so antibiotics are not needed. In cases of pneumonia, urinary tract infections, etc., antibiotics are required.

"Children with coughs do not necessarily need to take antibiotics. In many cases, just using drugs to treat the symptoms will help them recover quickly. For coughs, use expectorants and cough suppressants, or for runny or stuffy noses, use saline, vasoconstrictors, and antihistamines. If you have a fever and sore throat, take paracetamol and rest, drink plenty of water...", Associate Professor Dung emphasized.

According to him, the cause of rhinopharyngitis in children can be viruses or bacteria. Doctors can completely rely on clinical symptoms and tests to distinguish between viral and bacterial diseases (70-80% are caused by viruses). If it is caused by viruses, the patient may have symptoms such as conjunctivitis, runny nose, cough, diarrhea, viral rash... If it is caused by bacteria, common symptoms are fever above 38.5 degrees Celsius, swollen and painful lymph nodes in the neck, headache, hemorrhagic spots in the palate, abdominal pain, sudden onset (under 12 hours), secretions in the throat, tonsils...

For children with otitis media, in some cases, antibiotics may be required, such as children under 6 months; children 6 months to 2 years old if the diagnosis is certain or uncertain but the disease is severe; children over 2 years old with a certain diagnosis and severe disease. In other cases, only treat the symptoms and monitor after 2 days if the disease does not improve, then use antibiotics. It is important to keep the nose and throat clean, in some cases, even without nasal suction, the principle is that if the nose is clean, the ears will be dry.

“Clinical comparative evidence shows that 60% of patients with sinusitis lasting more than 10 days are due to bacterial infections. Otitis media with effusion in children is mostly not due to bacterial infections. Unspecified upper respiratory tract infections and acute bronchitis in previously healthy bodies are mainly caused by viruses. However, not everyone knows this or knows but still uses antibiotics, even doctors,” Associate Professor Dung emphasized.

TAccording to this expert, many mothers trust too much in using antibiotics without knowing the dangers behind it, it has many different side effects.

The first side effect that all doctors fear is allergy. Allergy can cause anaphylactic shock, which occurs very quickly and can be fatal without being predictable. Even a delayed allergy is extremely dangerous, leading to severe antibiotic poisoning and death after 1-2 weeks. The second side effect is diarrhea - this is the most common side effect.

The third little-known side effect is drug resistance. Antibiotic resistance means that antibiotics are no longer effective in the treatment process. Associate Professor Dung himself has encountered many cases of children becoming seriously ill, even dying, due to antibiotic abuse.

“There are many children with severe pneumonia, doctors have changed all the good antibiotics from old to new but still have no effect, patients die because all antibiotics are resistant to the bacteria. In addition, many children also suffer from side effects due to antibiotic abuse such as diarrhea, which takes 2-3 months to stop, which is not uncommon. Antibiotics are considered 'reserves' for use in truly emergency cases, so they should not be abused,” Associate Professor Dung shared.

According to VnExpress