I realize there is so much talk and education on how we should prescribe antibiotic more appropriately. A discussion on antibiotic stewardship may sound very sexy but the public may not be able to connect to such term. In essence, antibiotic stewardship is an initiative to promote appropriate antibiotic prescribing, to improve patient outcomes and to reduce antibiotic resistance. Maybe making it personal will help – and I mean let’s look at my daughters’ antibiotic use.

Actually, they haven’t had any course of antibiotic yet. My two daughters are 3 and 6 respectively and I have yet to give them a single course of oral antibiotic – at least not yet. I have not exposed them to the ubiquitous amoxicillin, cefuroxime or other antibiotics commonly prescribed for the common cold or respiratory infections.

But they were not always well and healthy.

They both have had their share of respiratory infections, stomach flus and many febrile episodes requiring a day or two off from school or day care. But they did not receive any antibiotic and got better on their own with some rest and tender loving care. So I can confirm personally that many of my kids unwell episodes were likely due to viral infections.

I also did not waste money on any cough and cold preparations. I have invested in a reliable tympanic thermometer and always have a supply of acetaminophen or ibuprofen for any new onset fever.

That’s not to say every kid will be able to be free of antibiotic exposure. For people with respiratory conditions such as reactive airway disease, asthma, congenital heart disease, cystic fibrosis or other immunocompromised conditions, their conditions are very different and may justifiably require antibiotics.

But for many otherwise healthy kids, antibiotic is often unnecessary, exposing them to side effects and increasing the risk of antibiotic resistance.   Many parents panic when their kids become unwell and feel that the antibiotic is a solution or a gateway to getting better. That is not true at all.  Here are few things I do when my kids become unwell:

  • Observe them closely – how are they different?
    • Are they eating well?
    • Are they drinking well?
    • Are they playing well?


  • If they have a temperature (e.g. above 38.5°C) and uncomfortable, may need to give some acetaminophen or ibuprofen to treat the fever.


  • Monitor how the fever or other symptoms are resolving or progressing. To me, this is the biggest sign to indicate if there is improvement or not and whether there is a need to visit the physician or urgent care clinic.


  • But the most important point is that as a parent, you are the best judge for your kids’ health. Even after a visit to your doctor and your kid has not improved within 2-3 days or you don’t feel right, connect with the health care system again.


But often times, kids will get better with or without antibiotics.