Course for Concern

Friday, 05.05.2017

Do you believe that antibiotics can accelerate your child’s recovery from the cold or flu? Or for any other ailment for that matter? It now appears that our incessant search for a quick fix has led to an overdependency on antibiotics—and a resulting medical quagmire that can’t be quickly fixed.

According to a Reuters report from 2013, a European survey showed that half of all respondents wrongly believed that antibiotics are effective to combat the common cold and flu. If this misconception is already prevalent in Europe, how much more so in China, where western medicine has taken hold as yet another modern miracle and even viewed as superior to traditional herbal remedies. 

Warning bells toll… but what’s the warning about?

It’s about our relationship with antibiotics… and how it’s spiralled out of control.

The rose-tinted glasses come off 
Simply put, the relationship is like a love story turned toxic—to the point where one party (in this case, bacteria) begins resisting the advances of the other (the antibiotics) when, once upon a time, 
their meeting led to the desired actions and ensuing result. But how did it all go so wrong since that glorious year of 1928, when Professor Alexander Fleming discovered penicillin, the world’s first true antibiotic?

Like the love affair analogy, what happened was external interference, similar to the actions of a third party. It led to us—or the bacterial infections in our bodies—becoming increasingly resistant to antibiotics, in what has become known as antibiotic-resistance.

Antibiotics resistance occurs when “bacteria and other microorganisms grow the ability to survive with the lethal doses of an antibiotic drug. More precisely, it is the loss of antibacterial properties of an antibiotic,” defines pharmacist and medical writer Imtiaz Ibne Alam.

Also alarming is the recent advent of superbug infections—bacterial infections that have not only developed a resistance to common antibiotic treatments, but are also more severe and last longer. Superbug infections can be potentially deadly to young children and the elderly, whose natural immune systems may not be as robust as the rest of the healthy general population. 

"Antibiotics are only effective in treating illnesses caused by bacteria."

Quick-fix quagmire
Imagine if the misuse of antibiotics were to begin at a young age, without even identifying whether bacteria, virus or some other microorganism is responsible for the infection. Making that proper distinction is an important first step as antibiotics are only effective in treating illnesses caused by bacteria, and have no potency in killing or stopping the growth of viruses.

Doctors are not the only ones responsible for this problem. Patients have an equally important role when it comes to knowing the limitations of antibiotic treatments instead of sticking to the outdated and mistaken view that it is a cure-all. When prescribed antibiotics, they should ensure that the entire course is completed and they should also refrain from adjusting the dosage and frequency of the medication based on self-assessment of their symptoms. 

Besides human interference that has rendered antibiotics to become less effective, another element responsible for this is—surprise, surprise—bacteria itself. In fact, the biological warfare that’s being waged could be likened to the reality-TV show Survivor. Similarly, the bacteria’s mission is to “Outwit—Outplay—Outlast” the invading antibiotics by disarming them, and numerous bacterial strains have already succeeded or made headway in the inactivation of these formerly lifesaving drugs.

The cold and flu: spotting the signs

The two most common respiratory conditions your child is likely to be inflicted with during the early years are the cold and the flu, with most kids catching viral colds around six to eight times a year from birth until they are around age 3. It would thus certainly be helpful for parents if they have some knowledge of both these infections, and what their differences are. Another reason for this is because antibiotics are frequently requested by parents whenever their child presents with the symptoms usually associated with the cold and flu. Some parents who are too reliant on antibiotics may also fear that these seemingly harmless symptoms may escalate into a more serious condition that could possibly be life threatening for their child.

These fears are not unfounded. A 2012 report by the UK-based International Scientific Forum on Home Hygiene, noted that acute respiratory illness costs the lives of an estimated 1.5 million children aged under five every year, while a child also faces a higher risk of coming down with around three to six episodes of acute respiratory illness within the first year of life.

However, despite the severity of respiratory illnesses and its risk to the health of young children worldwide, the truth remains that fighting viral infections with antibiotics is unhelpful and continued misuse of such prescription medicine is likely to compromise the body’s natural immunity in the 
long run.

I used to be an ignoramus in this department too, and my misperception was that only the flu needed to be treated with antibiotics. In my opinion, the flu was caused by a seasonal bacteria and the “evidence” was in the accompanying fever which “proved” that the body was actively fighting off the infection. So you can imagine how surprised I was when I learned that the flu, like the cold, is actually a respiratory viral infection. The flu, however, is caused by the influenza virus, which usually presents as two or three different strains every year.

Immunologists have thus been able to develop vaccines such as Tamiflu to counter the flu because of the relative scarcity in flu viral strains. In contrast, the cold has more than 200 strains of viruses (good reason why it is typically referred to as the “common cold”), and the sheer number makes it virtually impossible to manage. 

As a general reference, here are some differences between a cold and a flu. You may notice that the symptoms are very similar, but usually they vary in intensity and duration. In addition, if milder symptoms like sneezing and watery eyes persist for more than two weeks, the condition may likely be due to an allergy rather than a virus:

Although infants and young children appear more susceptible to falling ill more often with the cold or flu, these bouts usually pass without incident and will also decrease in frequency as they get older and their immune systems grow stronger. That is why it is especially important during their formative years to take extra precautions—don’t resort to antibiotics too often and also refrain from pressing your doctor for a course if he chooses not to write a prescription for your child. Any leftover antibiotics lying around in your medicine cupboard should also not be given to your child.

However, parents should be alert for any of these emergency signs during the period when your child is still infectious and should be recovering:
• Develops a fever accompanied with a rash (may indicate an ailment other than the flu)
• Breathing is fast or your child appears to be struggling to breathe
• Skin has a bluish tinge, denoting lack of oxygen
• Does not want to wake up or interact normally; or becomes extremely cranky to the point of resisting physical contact
• Lips are dry and cracked due to inadequate intake of fluids which ups the risk for dehydration
• Flu symptoms return after showing signs of improvement or recovery: this could highlight an underlying condition that may not be the original flu diagnosis 

No antibiotics? No worries!
Now that you can abstain from giving your child a round of antibiotics when he’s down with a cold or flu, are you aware of the alternative treatments available? Remember that colds and flus are viral infections, and antibiotics are far from being an effective remedy—in reality, your child would fare much better with no medical intervention whatsoever, just lots of bed rest and drinking plenty of fluids.  

While the common cold is self-limiting and there is no cure for it once your child catches the virus, there are fortunately over-the-counter antidotes and supplements available that may offer relief to the most wretched of symptoms. Take, for example, PediaTech Immunped, a nutritional supplement that is a good source of zinc and vitamin C. In the process, taking a once daily recommended dose of Immunped may prove beneficial in helping your child fight off the cold or flu virus; reduces the risk of getting bacterial pneumonia and also supports and boosts natural immunity.

When giving over-the-counter remedies to your child, it also helps if the taste is palatable. Mary Poppins once sang, “a spoonful of sugar makes the medicine go down”—but parents don’t have to take such extreme measures as Immunped has a pleasant apple-flavour without the metallic taste of zinc. Immunped is a good way to supplement your child’s diet with zinc, an important element that bolsters the body’s natural immunity and promotes healthy cell formation in growing children. Immunped also contains ascorbic acid, a source of vitamin C which the medical field has long recognised as a powerful antioxidant that helps strengthen the immune system.

As such, parents can even give their child Immunped as a nutritional supplement whether or not they have a cold. Dosing with Immunped at the first onset of symptoms (usually within 48 hours) may also may decrease the severity and length of a cold—similar to Tamiflu’s effects on the flu. Where Tamiflu is an antiviral medicine that requires a prescription though, Immunped can be purchased off the shelf. 

Remaining precautions
Care and judgement should still be exercised when treating these infections with over-the-counter antidotes. Make sure that you read the instructions carefully and stick to the prescribed dosage. Keep the information leaflet as well, which will contain the list of active and inactive ingredients, side effects (risk of allergies), and/or any data from clinical studies for your reference.

For fevers, aches and pains in children aged at least six months, the generic forms of paracetamol (also known as acetaminophen) or ibuprofen may be given to alleviate these symptoms (do not give the latter to your child on empty stomch or if he is dehydrated or vomiting). An exception, however, is aspirin, or any medicine containing aspirin, even though these may be obtained over the counter as well. In fact, the American Academy of Pediatrics recommends that children and teenagers who have viral infections such as the cold, refrain from taking such medicine. This is due to several studies linking aspirin use to the development of Reye’s syndrome in children who are recovering from flu or chickenpox. This rare and debilitating illness can affect all body organs, but most often the liver and brain, with the risk of brain damage and even death, particularly in children between the ages of 3 and 12.

Cough is another common symptom in the cold and flu, but it is also recommended that children under age 3 especially should not consume any cough suppressants, unless prescribed by their paediatrician. 

This is because the instinctive reflex of coughing may actually help in eliminating the lower respiratory tract of mucous and serves as a natural way to clear the airways of very young children. 

For congestion in the upper respiratory tract (the nasal passages), parents may try using a rubber suction bulb to draw out excess mucous from the nostrils; if this is too thick, saline nose drops may be applied to loosen the secretions. Keeping a bedroom humidifier on as your child sleeps may also help ease breathing through the nose.  

Be it the common cold or influenza virus, get your child to practise good personal hygiene at all times. If you’d like to take extra precautions—especially during flu season—take note that it takes around two weeks for a vaccine to be effective as protective antibodies develop during this period. Children receiving the flu vaccine for the first time also need two doses delivered one month apart. The Health Promotion Board (HPB) in Singapore highlights the peak flu season in Singapore as the months between December and February, and from May to July. The HPB also recommends getting the flu vaccination annually as the best possible protection as flu strains are constantly changing and a child’s natural immunity to flu viruses will wane over time.

The more often a doctor prescribes an antibiotic for a viral ailment, the greater the likelihood of antibiotic-resistant conditions surfacing in future. Stake the biggest claim over your family’s future health by resisting antibiotics of your own accord when such treatment is obviously not needed. Natural antibodies or manmade antibiotics? You can go up in arms to resist, to your advantage.

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