ANTIBIOTIC USE IN PAEDIATRIC PATIENTS
APRIL 18, 2019 @ 8.00PM
Not all newborns are born healthy, especially premature ones. Unfortunately, some of them may even contract congenital infections which are usually caused by a bacterium called Group B Streptococcus (GBS).
Dr Lim Ee Tang, Consultant Paediatrician (pix) explained that this bacterium is found in a mother’s birth canal and may be passed to the newborn before or during delivery, possible causing complications such as sepsis (blood infection), pneumonia (lung infection) and meningitis (brain infection).
"Paediatricians usually opt for antibiotics to treat GBS as it is a bacterial infection and without these drugs, the infant may suffer these complications."
Proper antibiotic use in children
He was stern when pointing out that parents should ensure their children complete the entire course of antibiotics to kill all the bacteria.
"Never save antibiotics for the next time your child gets sick because each antibiotic is unique in targeting a respective bacterium, having no effect towards a different ailment."
Furthermore, taking the wrong medication can cause the child’s condition to worsen, where they experience unpleasant side effects such as an upset stomach, diarrhoea or even skin rash.
“I have had parents and grandparents request for antibiotics even when it is not necessary, thinking that it offers a fast solution. I would take this opportunity to then educate them on the proper and correct use of antibiotics."
“Sometimes the challenge with this is parents are unhappy when they don’t get antibiotics and they then visit another doctor. As a paediatrician, it is important to validate parents’ concerns, letting them know that at the end of the day both parties want what’s best for the child."
“In my practice, I find that fever is a very worrying ailment for parents. In the case where the child is still active, I advise parents to monitor the child for about two to three days. If there’s no improvement, I will ask them to come back for a reassessment in which I perform a blood test or nasal swab depending on the child’s condition. This determines the underlining cause whether bacterial or viral, justifying the need for an antibiotic prescription."
Antibiotic prescription guidelines
The Ministry of Health has produced the National Antibiotic Guideline 2014 as a clear and structured guide for antibiotic prescription. This is a very resourceful tool in identifying the right type of prescription for all patients including infants, children and adolescents. When antibiotics are necessary for children, the dosage prescribed is in accordance to the child’s weight as this would affect the absorption rate.
“As a paediatrician, I usually try to select antibiotics treatment for my patients which are active against a selected group of bacteria, targeting a specific infection, limiting the resistance of the bacterial while sparing the beneficial bacteria. In my practice, I don't use the same antibiotics throughout the year. I will usually rotate the different groups of antibiotics to limit the spread of bacterial resistance,” he concluded.
Importance of vaccinating children
He recommend parents to get their children vaccinated as this not only provides immunisation but also prevents the need for antibiotics. Inherently, this reduces antibiotic resistance.
The World Health Organisation shared that an estimated 11 million days of yearly antibiotic use can be prevented if globally, all children were vaccinated against the Streptococcus pneumoniae bacteria (which can cause pneumonia, meningitis and middle ear infections).
Antimicrobial resistance is a serious, debilitating problem that can very much put our public health at a crisis. A global effort involving private and public sectors is required to curb this issue.
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