Article at a Glance

  • Report finds that antibiotics are being over prescribed for upper respiratory infections in children.
  • Overusing antibiotics creates infectious organisms that are resistant to antibiotics.
  • Antibiotics only work on bacteria, not viruses. Using an antibiotic on a virus is not only unhelpful but can cause harmful side effects.

Whether or not an antibiotic should be prescribed for your child’s running nose, sore throat, or earache may seem like a minor question. But according to a recent report by the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) how we treat these upper respiratory infections could have serious consequences.

Since we started using antibiotics 70 years ago, many infectious organisms have started to adapt to the antibiotics. As a result, these infections are becoming resistant to antibiotics—making them harder to treat and much more dangerous.

Overusing antibiotics can accelerate this process. The report found that every year about 10 million antibiotic prescriptions are made for upper respiratory infections when they are not needed. By more judiciously prescribing antibiotics, we can help preserve their effectiveness.

In 2013, Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention, issued a stark warning, “If we are not careful, we will soon be in a post-antibiotic era. And for some patients and for some microbes, we are already there.”

To help doctors better assess when antibiotics are needed for children, the AAP and CDC report outlines what to look for when prescribing antibiotics for the most common upper respiratory infections; including ear infections, sinus infections, and strep throat.

Although the report is aimed primarily at doctors, here are a few things you need to know:

  • Not all infections require a visit to the doctor. For most colds, the only thing you can do is treat the symptoms and wait for your body’s natural defenses to do their job. Often the symptoms can last up to 10 days.
  • Our site’s “Is Your Child Sick?” section can help you determine if your child has a viral or bacterial infection.
  • Most upper respiratory infections are caused by viruses. Antibiotics only work on bacteria, not viruses. Prescribing an antibiotic for a virus is not only unhelpful but often causes side effects like diarrhea, rashes, vomiting, yeast infections, and nausea. These side effects can result in even more office visits and can leave you feeling miserable for longer.
  • Antibiotics not only kill the harmful bacteria, but also all the good bacteria. This can cause other health problems. If an antibiotic is needed, try to use the narrowest spectrum antibiotic possible. Using a broad-spectrum antibiotic when it is not needed contributes to antibiotic resistance and is more likely to kill other helpful bacteria in your body.
  • Ear infections are most often viral and will go away on their own. If your child is older and not in a lot of pain, don’t be surprised if your doctor advises you to wait a few days to see if it clear up on its own. Antibiotics are most likely to be helpful in younger children who are in serious pain or who have an infection in both ears.
  • Antibiotics are generally helpful for runny noses and coughs only when the symptoms have lasted for a long time, are getting worse, or are very serious.
  • Antibiotics are not helpful for sore throats unless it is strep throat. Strep throat is usually accompanied by swollen lymph nodes or tonsils and a fever. Your doctor can order a lab test to be sure.
  • If your child is prescribed an antibiotic, don’t be afraid to ask your doctor questions. Find out the side effects and ask if an antibiotic is really needed.

More Information:

Principles of Judicious Antibiotic Prescribing for Upper Respiratory Tract Infections in Pediatrics (

American Academy of Pediatrics Advises Physicians to Use Antibiotics Judiciously (

Be cautious with antibiotics for kids: committee (

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Report Cautions Doctors About Prescribing Antibiotics for Children

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