Antibiotics For Babies: Safety, When To Give And Side Effects


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Antibiotics or antibacterials are medications that fight bacterial infections. They may act by stopping the growth (bacteriostatic) or destroying (bactericidal) the bacteria. Broad-spectrum antibiotics target many bacteria, and narrow-spectrum antibiotics are prescribed for specific bacterial infections.

Single or combination antibiotic therapies are given depending on the condition. Antibiotics can be given orally as capsules, tablets, or syrup to babies. Intramuscular injections or intravenous (IV) routes can also be used to deliver antibiotics. Severe bacterial infections usually require hospitalization and intravenous antibiotics. Skin bacterial infections are treated with topical antibiotics in the form of creams, lotions, or ointments.

Read this post to learn about the use and side effects of antibiotics in babies and the ways to avoid excess antibiotic use.

Need For Antibiotics In Babies And Toddlers

Your baby or toddler receives antibiotics if they have a bacterial infection. Although bacteria are part of the normal microflora in the human body, some of them and other bacteria may cause infections in certain circumstances.

The following conditions usually require antibiotics (1).

  • High fever due to bacterial infection requires antibiotic treatment. Broad-spectrum antibiotics, such as penicillin, ampicillin, or amoxicillin, are usually prescribed for high fever before the culture results are available. Specific antibiotics are given after the laboratory analysis is available. Doctors may also diagnose the type of bacterial infection causing fever by observing other signs and symptoms in the baby.
  • Ear infections require antibiotics such as amoxicillin. Excessive crying, ear pulling, loss of appetite, and fever could indicate ear infection in babies.
  • Bacterial pneumonia in babies is treated with antibiotics. Although the specific bacterium is not identified in some cases, doctors may prescribe antibiotics since pneumonia complications can be dangerous for infants.
  • Whooping cough is treated with antibiotics such as azithromycin, erythromycin, or clarithromycin.
  • Urinary tract infections, such as cystitis and pyelonephritis, caused by bacteria are treated with antibiotics. The bacterial UTI is usually confirmed by microscopy and urine culture.
  • Sinus infections (sinusitis) due to bacteria could need antibiotic treatment since, if left untreated, it may increase the risk of complications, such as meningitis.
  • Strep throat is also treated with antibiotics since the infection could increase the risk of rheumatic fever.
  • coli infections, group B streptococcus (GBS), and listeria infections soon after birth may require antibiotic treatment. Babies may contract these bacteria during vaginal delivery.

Doctors may order a complete blood count and blood culture to confirm bacterial infections before prescribing antibiotics. Antibiotics and their administration route are decided based on the type of infection and baby’s age, weight, and health status. 

Ways To Avoid Overuse Of Antibiotics

Inappropriate and unnecessary use of antibiotics may result in antibiotic resistance and other problems. The following tips may help in safe antibiotic use in babies (2).

  • Always seek a prescription of antibiotics from a pediatrician
  • Never use antibiotics for viral infections such as flu or cold
  • Follow the recommended dose and course of treatment even though the baby gets better
  • Do not share antibiotics among siblings or peers though they have similar conditions
  • Do not self-medicate with antibiotics
  • Seek a new prescription from the pediatrician if you run out of antibiotics

Most of the bacterial infections get better within one or two days after beginning antibiotic therapy. However, you have to complete the prescribed course of treatment. You may contact the pediatrician if there is no improvement in symptoms within two days of treatment. 

Side Effects And Long-Term Effects Of Antibiotics In Babies

Antibiotics may have side effects in some babies. It is advisable to inform the pediatrician about the baby’s history of antibiotic side effects before the prescription. Pediatricians may prescribe a different group of antibiotics that may not cause similar side effects.

Common antibiotic side effects may include the following (3).

  • Allergic reactions, such as skin rashes that look like hives, may occur due to some antibiotics.
  • Antibiotic-associated diarrhea is commonly caused by erythromycin and co-amoxiclav. This may occur during treatment or up to a few weeks after the treatment.
  • Drug reactions may also cause skin
  • Teeth staining may occur with the use of some antibiotics, such as tetracycline, minocycline, and doxycycline.
  • Drug-induced fever may be seen with some intravenous (IV) antibiotics

Although they are common, most of the above-listed side effects are not life-threatening and resolve after treatment. Allergic reactions may require corticosteroids or antihistamines in some babies, and antifungals help to manage yeast infections.

Some antibiotics may cause adverse drug-related emergency room visits among babies. Adverse antibiotic side effects and long-term effects may include the following (4) (5) (6).

  • Anaphylaxis is a life-threatening allergic reaction including breathing trouble and/or hypotension (low blood pressure) with various allergy symptoms.
  • Musculoskeletal problems, such as tendon rupture, pain, and swollen joints, may occur with the use of ciprofloxacin (Cipro) and other fluoroquinolones.
  • Pill esophagitis is inflammation of the esophagus due to irritation of the mucosa from large antibiotic pills, such as doxycycline.
  • Ototoxicity is seen with the use of aminoglycosides, such as gentamicin. Antibiotic-induced cochlear or vestibular damage may result in hearing loss.
  • Stevens-Johnson syndrome is a life-threatening hypersensitivity that causes flu-like symptoms with mucosal ulcers or erosions on the nose, mouth, genitals, and eyes.
  • Toxic epidermal necrolysis (TEN) is a severe form of Steven-Johnson syndrome causing large areas of skin to peel away.
  • Red man syndrome involves itchy red rashes with angioedema and hypotension due to the use of intravenous vancomycin.
  • Clostridium difficile diarrhea and other gastrointestinal symptoms may occur due to some antibiotics.
  • Drug-induced lupus may occur in some babies treated with certain antibiotics, such as minocycline, for a longer duration.

Not all antibiotics cause side effects and long-term effects when taken at the right dose for a given time. Always seek prescriptions for antibiotics. If you notice side effects, never hesitate to inform the doctor since they may prescribe an alternative antibiotic for the same condition.

Antibiotics can help cure several infections that could cause adverse effects on babies. However, inappropriate use of antibiotics increases the risk of antibiotic resistance due to genetic changes in the bacteria. You may have to use more potent antibiotics or a combination of several medications to treat antibiotic-resistant infections. Therefore, always seek prescription to avoid antibiotic resistance and reduce the risk of side effects and other adverse long-term effects.


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