When to Use Antibiotics for Your Child

Antibiotics are medicines used to treat infections caused by bacteria. They don’t work for illnesses caused by viruses or an allergic reaction. In fact, taking antibiotics for reasons other than a bacterial infection can cause problems. Your child may have side effects from the medicine. And when your child really needs an antibiotic, it may not work as well.

When antibiotics won’t help your child 

Your child’s provider usually won’t prescribe an antibiotic for these conditions. You can help by not asking for antibiotics if your child has: 

• A cold. This is a viral illness. Your child may have a runny nose, stuffed-up nose, sneezing, coughing, headache, mild body aches, and fever. Nasal mucus may be white, green, or yellow. A cold gets better on its own in a few days to a week.

• The flu (influenza). This is a respiratory illness caused by a virus. It often goes away on its own in a week or so. Your child may have fever, body aches, sore throat, and fatigue.

• Bronchitis. This is an infection in the lungs most often caused by a virus. Your child may have coughing, phlegm, body aches, and a low fever. A common type of bronchitis is known as a chest cold (acute bronchitis). This often happens after a respiratory infection like a common cold. It can take weeks to go away, but antibiotics usually don’t help.

• Most sore throats. Sore throats are most often caused by viruses. But a sore throat may also be caused by the common bacteria streptococcus (strep throat). This is something your healthcare provider can easily test you for. It may feel scratchy or achy, and it may hurt to swallow. Your child may also have a low fever and body aches. A sore throat often gets better in a few days.

• Most ear infections. An ear infection may be caused by a virus or bacteria. It causes pain in the ear. A young child may pull at their ear. Antibiotics may not be prescribed. The infection often goes away on its own.

• Most sinus infections (sinusitis). This kind of infection causes sinus pain and swelling, and a runny nose. In most cases, it goes away on its own, and antibiotics don’t make recovery quicker.

• Allergic rhinitis. This is a set of symptoms caused by an allergic reaction. Your child may have sneezing, a runny nose, itchy or watery eyes, or a sore throat. Allergies are not treated with antibiotics.

• Low fever. A mild fever that’s less than 100.4°F (38°C) most likely doesn’t need treatment with antibiotics. 

• Most cases of diarrhea. Diarrhea is most often caused by viruses or food intolerance. Antibiotics will not make such symptoms go away. In fact, diarrhea is a common side effect of antibiotics. So they may make symptoms worse. There are times that bacteria in the gut may cause diarrhea. Your healthcare provider may test you for with a stool culture.

When antibiotics can help your child

Antibiotics can be used to treat:

• Strep throat. This is a throat infection caused by bacteria. Symptoms include a sore throat, white patches on the tonsils, red spots on the roof of the mouth, fever, body aches, and nausea and vomiting. Strep throat needs to first be confirmed with a test called a throat culture.

• Urinary tract infection (UTI). This is a bacterial infection of the bladder and the tube that takes urine out of the body. It can cause burning pain and urine that smells funny or is cloudy or tinted with blood. UTIs are very common. Antibiotics usually help treat these infections.

• Some ear infections. In some cases, your child’s healthcare provider may prescribe antibiotics for an ear infection. In other cases, ear infections may resolve without them. Your healthcare provider may advise a watch and wait approach instead.

• Some sinus infections. In some cases, your child’s healthcare provider may prescribe antibiotics. They may first need to make sure your child’s symptoms aren’t caused by a virus, fungus, allergies, or air pollutants such as smoke.

Helping your child feel better 

If your child’s infection can’t be treated with antibiotics, you can take other steps to help them feel better. Try the tips below:

• Let your child rest as much as needed.

• Make sure your child drinks water and other clear fluids.

• Keep your child away from smoke.

• Use over-the-counter medicine such as acetaminophen to ease pain or fever, as advised by your child’s healthcare provider. 

To treat sinus pain or stuffy nose:

• Put a warm, moist washcloth on your child’s nose and forehead.

• Use a nasal spray with medicine or saline, as advised by your child’s healthcare provider.

• Have your child breathe in steam from a hot shower.

• Use a humidifier or cool mist vaporizer in your child’s room.

• Remove mucus with a rubber suction bulb, if your child is young. 

To quiet a cough: 

• Use a humidifier or cool mist vaporizer in your child’s room.

• Have your child breathe in steam from a hot shower.

• Give an older child cough lozenges. Don’t give lozenges to a young child.

• Give your child honey if they are older than 1 year. 

To sooth a sore throat:

• Give your child ice chips or frozen juice pops to suck on.

• Give an older child throat lozenges. Don’t give lozenges to a young child.

• Use a sore throat spray on your child’s throat.

• Use a humidifier or cool mist vaporizer in your child’s room.

• Have your child gargle with saltwater.

• Have your child drink warm liquids. 

To ease ear pain: 

• Hold a warm, moist washcloth on your child’s ear for 10 minutes at a time. 

When to call your child's healthcare provider 

Call your child’s healthcare provider if your child is younger than 3 months old and has a fever. Also contact the healthcare provider if your child has any of these: 

• Symptoms that get worse

• Symptoms that last more than 10 days

• Trouble breathing

• No interest in eating

• Trouble swallowing

• Blood or pus from ears or in saliva or phlegm

• Fever (see Fever and children, below)

• Signs of dehydration, such as dry diapers, no tears, dry mouth, or weakness

• Excess drooling in a young child

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider