Download Six Smart Facts About Antibiotic Use

Six Smart Facts About Antibiotic Use
SIX SIMPLE AND SMART FACTS ABOUT ANTIBIOTIC USE
1. Antibiotics are life-saving drugs
Using antibiotics wisely is the best way to preserve their
strength for future bacterial illnesses.
2. Antibiotics only treat bacterial infections
If your child has a viral infection like a cold, talk to a
doctor or pharmacist about symptom relief. This may
include over-the-counter medicine, a humidifier, or
warm liquids.
3. Some ear infections DO NOT require an
antibiotic
A doctor can determine what kind of ear infection your
child has and if antibiotics will help. The doctor may
follow expert guidelines to wait a couple of days before
prescribing antibiotics since your child may get better
without them.
4. Most sore throats DO NOT require an antibiotic
Only 1 in 5 children seen by a doctor for a sore throat has
strep throat, which should be treated with an antibiotic. Your
child’s doctor can only confirm strep throat by running a test.
5. Green colored mucus is NOT a sign that an
antibiotic is needed
As the body’s immune system fights off an infection, mucus
can change color. This is normal and does not mean your
child needs an antibiotic.
6. There are potential risks when taking any
prescription drug
Antibiotic use can cause complications, ranging from an
upset stomach to a serious allergic reaction. Your child’s
doctor will weigh the risks and benefits before prescribing
an antibiotic.
Get Smart symptom relief tips & tools for your child at:
www.cdc.gov/getsmart or call 1-800-CDC-INFO (232-4636)
National Center for Immunization and Respiratory Diseases
Division of Bacterial Diseases
CS232630-A
Viruses cause common illnesses that antibiotics
CANNOT treat like:
•• Colds
•• Influenza (the flu)
•• Runny noses
•• Most coughs
•• Most bronchitis
•• Most sore throats
•• Most sinus infections
•• Some ear infections
Viral illnesses, like colds, usually go away without
treatment in a week or two. Even many bacterial ear
infections go away by themselves. When an antibiotic
is not prescribed, ask your child’s doctor or pharmacist
what can be used to relieve symptoms.
Taking antibiotics for viral illnesses:
•• Will NOT cure your child’s illness
•• Will NOT help your child feel better
•• Will NOT keep others from catching your child’s
illness
Bacteria cause illnesses like strep throat that are often
treated successfully with antibiotics.
Remember–there are potential risks when taking any
prescription drug. Antibiotics should only be used
when your child’s doctor determines they are needed.
Most cough and cold
illnesses are caused
by viruses. Antibiotic
use can only cure
bacterial illnesses–not
viral illnesses.
Antibiotic use can:
•• Kill good bacteria in your child’s body, which may
lead to complications, such as diarrhea or yeast
infection.
•• Cause a serious allergic reaction that may require
hospitalization.
•• Result in an antibiotic-resistant infection. Resistant
bacteria are stronger and harder to kill. They can stay
in your child’s body and can cause severe illnesses
that cannot be cured with antibiotics. A cure for a
resistant infection may require stronger treatment–
and possibly a hospital stay.
Talk with your child’s doctor about the best way to
care for your child during this illness.
Viruses cause common illnesses that
antibiotics CANNOT treat like:
•• Colds
•• Influenza (the flu)
•• Runny noses
•• Most coughs
•• Most bronchitis
•• Most sore throats
•• Most sinus infections
•• Some ear infections
Viral illnesses, like colds, usually go away
without treatment in a week or two. Even
many bacterial ear infections go away
by themselves. When an antibiotic is not
prescribed, ask your child’s doctor or
pharmacist what can be used to relieve
symptoms.
Taking antibiotics for viral illnesses:
•• Will NOT cure your child’s illness
•• Will NOT help your child feel better
•• Will NOT keep others from catching
your child’s illness
Bacteria cause illnesses like strep throat
that are often treated successfully with
antibiotics.
Remember–there are potential risks when
taking any prescription drug. Antibiotics
should only be used when your child’s doctor
determines they are needed.
Antibiotics Aren’t
Always the Answer
Antibiotic use can:
•• Kill good bacteria in your child’s body,
which may lead to complications, such as
diarrhea or yeast infection.
•• Cause a serious allergic reaction that may
require hospitalization.
•• Result in an antibiotic-resistant infection.
Resistant bacteria are stronger and harder
to kill. They can stay in your child’s body
and can cause severe illnesses that cannot
be cured with antibiotics. A cure for a
resistant infection may require stronger
treatment–and possibly a hospital stay.
Talk with your child’s doctor
about the best way to care
for your child during this
illness.
Get Smart symptom relief
tips & tools for your child at:
www.cdc.gov/getsmart or call
1-800-CDC-INFO (232-4636)
CS232630-B
Most cough and cold illnesses are caused
by viruses. ANTIBIOTIC use can only cure
bacterial illnesses–not viral illnesses.
5. Green
SIX SIMPLE AND SMART FACTS
ABOUT ANTIBIOTIC USE
3. Some ear
infections DO
NOT require
an antibiotic
1. Antibiotics
are life-saving
drugs
Using antibiotics wisely is
the best way to preserve
their strength for future
bacterial illnesses.
2. Antibiotics
A doctor can determine
what kind of ear infection
your child has and if
antibiotics will help. The
doctor may follow expert
guidelines to wait for a
couple of days before
prescribing antibiotics
since your child may get
better without them.
4. Most sore
only treat
bacterial
infections
throats DO
NOT require
an antibiotic
If your child has a viral
infection like a cold, talk
to a doctor or pharmacist
about symptom relief.
This may include overthe-counter medicine,
a humidifier, or warm
liquids.
Only 1 in 5 children seen by
a doctor for a sore throat
has strep throat, which
should be treated with an
antibiotic. Your child’s
doctor can only confirm
strep throat by running a
test.
colored
mucus is
NOT a sign
that an
antibiotic
is needed
As the body’s
immune system
fights off an
infection, mucus can
change color. This
is normal and does
not mean your child
needs an antibiotic.
6. There are
potential
risks when
taking any
prescription
drug
Antibiotic use can cause
complications, ranging
from an upset stomach
to a serious allergic
reaction. Your child’s
doctor will weigh the
risks and benefits before
prescribing an antibiotic.
Antibiotics Aren’t Always the Answer
SIX SIMPLE AND SMART FACTS ABOUT ANTIBIOTIC USE
1. Antibiotics are life-saving drugs
Using antibiotics wisely is the best way to preserve their
strength for future bacterial illnesses.
2. Antibiotics only treat bacterial infections
If your child has a viral infection like a cold, talk to a
doctor or pharmacist about symptom relief. This may
include over-the-counter medicine, a humidifier, or
warm liquids.
3. Some ear infections DO NOT require an
antibiotic
A doctor can determine what kind of ear infection your
child has and if antibiotics will help. The doctor may
follow expert guidelines to wait a couple of days before
prescribing antibiotics since your child may get better
without them.
4. Most sore throats DO NOT require an antibiotic
Only 1 in 5 children seen by a doctor for a sore throat has
strep throat, which should be treated with an antibiotic. Your
child’s doctor can only confirm strep throat by running a test.
5. Green colored mucus is NOT a sign that an
antibiotic is needed
As the body’s immune system fights off an infection, mucus
can change color. This is normal and does not mean your
child needs an antibiotic.
6. There are potential risks when taking any
prescription drug
Antibiotic use can cause complications, ranging from an
upset stomach to a serious allergic reaction. Your child’s
doctor will weigh the risks and benefits before prescribing
an antibiotic.
Get Smart symptom relief tips & tools for your child at:
www.cdc.gov/getsmart or call 1-800-CDC-INFO (232-4636)
National Center for Immunization and Respiratory Diseases
Division of Bacterial Diseases
CS232630-C
Adult Treatment Recommendations
Antibiotic prescribing guidelines establish standards of care and focus quality improvement efforts. The table below summarizes the most recent
recommendations for appropriate antibiotic prescribing for adults seeking care in an outpatient setting.
Condition
Acute
rhinosinusitis1, 2
Epidemiology


About 1 out of 8 adults
(12%) in 2012 reported
receiving a diagnosis of
rhinosinusitis in the
previous 12 months,
resulting in more than 30
million diagnoses.
Ninety–98% of
rhinosinusitis cases are
viral, and antibiotics are not
guaranteed to help even if
the causative agent is
bacterial.
Diagnosis


Acute
uncomplicated
bronchitis3-5

Cough is the most
common symptom for
which adult patients visit
their primary care
provider, and acute
bronchitis is the most
common diagnosis in these
patients.



Common cold or
non-specific
upper respiratory
tract infection
(URI)6,7


The common cold is the
third most frequent
diagnosis in office visits,
and most adults
experience two to four
colds annually.
At least 200 viruses can
cause the common cold.

Management
Diagnose acute bacterial rhinosinusitis based
on symptoms that are:
o Severe (>3-4 days), such as a fever
≥39°C (102°F) and purulent nasal
discharge or facial pain;
o Persistent (>10 days) without
improvement, such as nasal discharge or
daytime cough; or
o Worsening (3-4 days) such as
worsening or new onset fever, daytime
cough, or nasal discharge after initial
improvement of a viral upper respiratory
infections (URI) lasting 5-6 days.
Sinus radiographs are not routinely
recommended.
If a bacterial infection is established:

Watchful waiting is encouraged for
uncomplicated cases for which reliable
follow-up is available.

Amoxicillin or amoxicillin/clavulanate is the
recommended first-line therapy.

Macrolides such as azithromycin are not
recommended due to high levels of
Streptococcus pneumoniae antibiotic
resistance (~40%).

For penicillin-allergic patients, doxycycline
or a respiratory fluoroquinolone
(levofloxacin or moxifloxacin) are
recommended as alternative agents.
Evaluation should focus on ruling out
pneumonia, which is rare among otherwise
healthy adults in the absence of abnormal
vital signs (heart rate ≥ 100 beats/min,
respiratory rate ≥ 24 breaths/min, or oral
temperature ≥ 38 °C) and abnormal lung
examination findings (focal consolidation,
egophony, fremitus).
Colored sputum does not indicate bacterial
infection.
For most cases, chest radiography is not
indicated.
Routine treatment of uncomplicated acute bronchitis
with antibiotics is not recommended, regardless of
cough duration.
Prominent cold symptoms include fever,
cough, rhinorrhea, nasal congestion,
postnasal drip, sore throat, headache, and
myalgias.
1
Options for symptomatic therapy include:

Cough suppressants (codeine,
dextromethorphan);

First-generation antihistamines
(diphenhydramine);

Decongestants (phenylephrine); and

Beta agonists (albuterol).

Decongestants (pseudoephedrine and
phenylephrine) combined with a first-generation
antihistamine may provide short-term symptom
relief of nasal symptoms and cough.

Non-steroidal anti-inflammatory drugs can be
given to relieve symptoms.

Evidence is lacking to support antihistamines (as
monotherapy), opioids, intranasal
corticosteroids, and nasal saline irrigation as
effective treatments for cold symptom relief.
Providers and patients must weigh the benefits and
harms of symptomatic therapy.
Pharyngitis8,9


Acute
uncomplicated
cystitis 10, 11

Group A beta-hemolytic
streptococcal (GAS)
infection is the only
common indication for
antibiotic therapy for sore
throat cases.


Only 5–10% of adult sore
throat cases are caused by
GAS.
Cystitis is among the most
common infections in
women and is usually
caused by E. coli.


Clinical features alone do not distinguish
between GAS and viral pharyngitis; a rapid
antigen detection test (RADT) is necessary to
establish a GAS pharyngitis diagnosis
Those who meet two or more Centor criteria
(e.g., fever, tonsillar exudates, tender cervical
lymphadenopathy, absence of cough) should
receive a RADT. Throat cultures are not
routinely recommended for adults.
Classic symptoms include dysuria, frequent
voiding of small volumes, and urinary
urgency. Hematuria and suprapubic
discomfort are less common.
Nitrites and leukocyte esterase are the most
accurate indicators of acute uncomplicated
cystitis
2

Antibiotic treatment is NOT recommended for
patients with negative RADT results.

Amoxicillin and penicillin V remain first-line
therapy due to their reliable antibiotic activity
against GAS.

For penicillin-allergic patients, cephalexin,
cefadroxil, clindamycin, or macrolides are
recommended.

GAS antibiotic resistance to azithromycin and
clindamycin are increasingly common.

Recommended treatment course for all oral beta
lactams is 10 days.
For acute uncomplicated cystitis in healthy adult
non-pregnant, premenopausal women:

Nitrofurantoin, trimethoprim/sulfamethoxazole
(TMP-SMX, where local resistance is <20%),
and fosfomycin are appropriate first-line agents.

Fluoroquinolones (e.g. ciprofloxacin) should be
reserved for situations in which other agents are
not appropriate.
References
1) Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (updated): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2
Suppl):S1-39.
2) Chow AW, Benninger MS, Itzhak B, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis.
2012;54(8):e72-e112.
3) Albert RH. Diagnosis and treatment of acute bronchitis. Am Fam Physician. 2010;82(11):1345-50.
4) Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough: ACCP evidence-based clinical practice guidelines. Chest.
2006;129(1 Suppl).
5) Gonzales R, Bartlett JG, Besser RE, et al. Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: Background. Ann
Intern Med. 2001;134(6):521-9.
6) Fashner J, Ericson K, Werner S. Treatment of the common cold in children and adults. Am Fam Physician. 2012;86(2):153-9.
7) Pratter MR. Cough and the common cold: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl): 72S-74S.
8) Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012
update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86-102.
9) Cooper RJ, Hoffman JR, Bartlett JG, et al. Principles of appropriate antibiotic use for acute pharyngitis in adults: Background. Ann Intern Med.
2001;134(6):509-17.
10) Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis
in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin
Infect Dis. 2011;52(5):e103-20.
11) Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitis. Am Fam Physician. 2011;84(7):771-6.
3
GET
SMART
About Antibiotics Week
RESISTANCE ANYWHERE
IS RESISTANCE EVERYWHERE
WWW.CDC.GOV/GETSMART
Antibiotic Resistance Can Travel the Globe
• Often called superbugs, some bacteria are already resistant to most or all known
antibiotics. One example is CRE, a family of germs that is resistant to our most powerful
drugs of last-resort.
• Sometimes called “nightmare bacteria” because they are so difficult to treat, CRE was
originally found in only one U.S. state but has spread.
• Klebsiella pneumoniae carbapenemase (KPC) infections, a type of CRE, were once seen in
limited locations in the U.S. but are now found throughout the country.
• Another type of CRE, caused by New Delhi metallo-beta-lactamase (NDM-1), was initially
identified in India, but is now present in several other countries including the U.S., Canada,
Netherlands, United Kingdom, Australia, and beyond.
Why We Must Act Now
Graphical Distribution of Klebsiella pneumonia carbapenemase (KPC) Infection
Did You Know?
1. Antibiotic resistance is one of
the world’s most pressing public
health threats.
States with KPC
producing organisims
2. Antibiotics are the most important
tool we have to combat lifethreatening bacterial diseases,
but using antibiotics can have
side effects.
3. Antibiotic overuse increases the
development of drug-resistant
germs.
4. Patients, healthcare providers,
hospital administrators, and
policy makers must work
together to use effective
strategies for improving antibiotic
use—ultimately improving
medical care and saving lives.
2001
2015
• The way we use antibiotics today or in one patient directly impacts how effective they will be tomorrow or in another patient; they are a shared resource.
• Antibiotic resistance is not just a problem for the person with the infection. Some resistant
bacteria have the potential to spread to others—promoting antibiotic-resistant infections.
• Since it will be many years before new antibiotics are available to treat some resistant
infections, we need to improve the use of antibiotics that are currently available.
Outpatient antibiotic use:
U.S. compared to Europe (2004)
Defined Daily Dose/1,000 inhabitants per day
GREECE
FRANCE
United States: 24.9
ITALY
UNITED STATES
LUXEMBERG
PORTUGAL
SLOVAKIA
ICELAND
IRELAND
ISRAEL
EUROPE
SPAIN
HUNGARY
Europe: 19.0
FINLAND
SLOVENIA
NORWAY
UNITED KINGDOM
LATVIA
GERMANY
NETHERLANDS
0
5
10
15
20
25
Source: Goosens et al. CID 2007;44:1091-5; erratum CID 2007; 44:1259
CS260605E
30
35
Global Health Professionals Can:
• Spread the message that antibiotic resistance is a global problem.
• Implement hospital infection-control measures to reduce the spread of multidrug-resistant strains and reinforce national
policies on prudent use of antibiotics, reducing the generation of antibiotic-resistant bacteria.
• Adhere to World Health Organization’s strong recommendations that governments focus control and prevention efforts in
four main areas:
1. Surveillance for antimicrobial resistance;
2. Rational antibiotic use, including education of healthcare workers and the public in the appropriate use of antibiotics;
3. Introduction or enforcement of legislation related to stopping the sale of antibiotics without prescription; and
4. Strict adherence to infection prevention and control measures, including safe handwashing measures, particularly in healthcare facilities.
• Develop relevant policies and coordinate international efforts with the support of WHO to combat antimicrobial resistance.
For more information, visit CDC’s Get Smart Program Website
Get Smart About Antibiotics Week http://www.cdc.gov/getsmart/week/index.html
Get Smart Resources for Policy Makers
http://www.cdc.gov/getsmart/week/educational-resources/policy-makers.html
Centers for Disease Control and Prevention
For more information, please contact Centers for Disease Control and Prevention.
1600 Clifton Road N.E., Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-63548
Email: [email protected] Web: http://www.cdc.gov/getsmart/
GET
SMART
ANTIBIOTIC RESISTANCE:
THE GLOBAL THREAT
About Antibiotics Week
WWW.CDC.GOV/GETSMART
Super-Resistant Bacteria: Problem Today, Crisis Tomorrow
• In India, 58,000+ babies died in one year from super-resistant bacterial infections,
which are usually passed on from their mothers1
• In the European Union, antibiotic resistance causes 25,000 deaths per year and
2.5m extra hospital days2
• In Thailand, antibiotic resistance causes 38,000+ deaths per year
and 3.2m hospital days2
Antibiotic resistance—when bacteria
no longer respond to the drugs
designed to kill them—is happening
right now across the world.
• In the United States, antibiotic resistance causes 23,000+ deaths
per year and more than 2m illnesses2
Global Action to Slow Resistance
• Improve Laboratory Capacity: Countries need medical labs
to identify bacteria and choose the right drugs to treat them. When
people get antibiotics without this testing, they:
−− Often get treatment that doesn’t help
−− Develop and spread resistant bacteria
−− Increase their risk for future resistant infections
• Develop National Tracking Programs: Countries need the infrastructure to
collect resistance data and report results globally. This information is necessary to:
The full impact is unknown. There
is no system in place to track
antibiotic resistance globally.
−− Target and measure prevention efforts
−− Drive policies that help stop spread
• Implement Antibiotic Stewardship Programs: To ensure antibiotics are here
when we need them, they must be prescribed and taken correctly now.
• Expand Infection Control Programs: Improving infection control practices in
healthcare settings is critical to prevent spread of antibiotic-resistant germs.
CDC’s Impact on a Global Threat
CDC’s proposed Antibiotic Resistance Solutions Initiative will:
• Allow standardized tracking of antibiotic resistance
internationally
Without urgent action, modern
medicine will be obsolete and
minor injuries will once again be
deadly.
• Prevent antibiotic resistance
• Improve antibiotic prescribing and use
• Boost communication of antibiotic resistance threats
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(13)70318-9/fulltext
1
Anticrobial Resistance Global Report on Surveillance, 2014. WHO Report.
http://www.who.int/drugresistance/documents/AMR_report_Web_slide_set.pdf?ua=1
2
CS260606C
GLOBAL THREAT
GET
SMART
About Antibiotics Week
WWW.CDC.GOV/GETSMART
FOR PARENTS
ANTIBIOTICS AREN’T ALWAYS
THE ANSWER
Many common infections are becoming resistant to antibiotics. As a parent, ask
questions to make sure your sick child is getting the best care possible, which might not
include an antibiotic.
The Facts:
• Antibiotics can have reactions and side effects.
Harmful effects from antibiotics, such as side effects and allergic reactions, cause 1 out
of 5 emergency department visits for adverse drug events and lead to 50,000 emergency
department visits in children each year.1
• Antibiotics can be overused and misused.
It is estimated that more than half of antibiotics are unnecessarily prescribed to children
in doctor office settings for cough and cold illness, most of which are caused by viruses.
• Antibiotics can only cure infections caused by bacteria, not viruses.
• Antibiotic resistance is growing.
An estimated 2 million illnesses and 23,000 deaths occur each year in the United States
due to antibiotic-resistant infections.2 Overuse and misuse of antibiotics are main drivers of resistance.
?
CS260605B
?
?
?
?
Questions to Ask Your Provider
If your child is sick, here are 3 important questions to ask your healthcare professional:
1. What is the best treatment for my child’s illness?
Antibiotics aren’t needed for common illnesses like colds, most sore throats, the flu, and even some ear infections. These illnesses are
often caused by viruses, which do not respond to antibiotics. Sometimes the
best treatment is symptom relief.
2. Is this the right antibiotic for the type of infection
my child has?
If an antibiotic will help your child, it’s important to use an antibiotic that is
designed to fight the bacteria causing your child’s specific illness. If your
healthcare professional says your child needs an antibiotic, ask if it’s the one
most “targeted” to treat the infection while causing the least side effects.
3. What can I do to help my child feel better?
Pain relievers, fever reducers, saline nasal spray or drops, warm
compresses, liquids, and rest may be the best things to help your child feel
better. Ask your healthcare provider or pharmacist what symptom relief is
best for your child.
Centers for Disease Control and Prevention
For more information, please contact Centers for Disease Control and Prevention.
1600 Clifton Road N.E., Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-63548
Email: [email protected] Web: www.cdc.gov/getsmart
Citations:
1
Bourgeois FT, et al. Pediatric adverse drug events in the outpatient setting: An 11-year national analysis. Pediatrics. 2009;124:e744-50.
2
CDC. Antibiotic Resistance Threats in the United States, 2013. 16 September 2013.
GET
SMART
About Antibiotics Week
WWW.CDC.GOV/GETSMART
FOR PARENTS
ANTIBIOTICS AREN’T ALWAYS
THE ANSWER
Many common infections are becoming resistant to antibiotics. As a parent, ask
questions to make sure your sick child is getting the best care possible, which might not
include an antibiotic.
The Facts:
• Antibiotics can have reactions and side effects.
Harmful effects from antibiotics, such as side effects and allergic reactions, cause 1 out
of 5 emergency department visits for adverse drug events and lead to 50,000 emergency
department visits in children each year.1
• Antibiotics can be overused and misused.
It is estimated that more than half of antibiotics are unnecessarily prescribed to children
in doctor office settings for cough and cold illness, most of which are caused by viruses.
• Antibiotics can only cure infections caused by bacteria, not viruses.
• Antibiotic resistance is growing.
An estimated 2 million illnesses and 23,000 deaths occur each year in the United States
due to antibiotic-resistant infections.2 Overuse and misuse of antibiotics are main drivers of resistance.
?
CS260605B
?
?
?
?
Questions to Ask Your Provider
If your child is sick, here are 3 important questions to ask your healthcare professional:
1. What is the best treatment for my child’s illness?
Antibiotics aren’t needed for common illnesses like colds, most sore throats, the flu, and even some ear infections. These illnesses are
often caused by viruses, which do not respond to antibiotics. Sometimes the
best treatment is symptom relief.
2. Is this the right antibiotic for the type of infection
my child has?
If an antibiotic will help your child, it’s important to use an antibiotic that is
designed to fight the bacteria causing your child’s specific illness. If your
healthcare professional says your child needs an antibiotic, ask if it’s the one
most “targeted” to treat the infection while causing the least side effects.
3. What can I do to help my child feel better?
Pain relievers, fever reducers, saline nasal spray or drops, warm
compresses, liquids, and rest may be the best things to help your child feel
better. Ask your healthcare provider or pharmacist what symptom relief is
best for your child.
Centers for Disease Control and Prevention
For more information, please contact Centers for Disease Control and Prevention.
1600 Clifton Road N.E., Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-63548
Email: [email protected] Web: www.cdc.gov/getsmart
Citations:
1
Bourgeois FT, et al. Pediatric adverse drug events in the outpatient setting: An 11-year national analysis. Pediatrics. 2009;124:e744-50.
2
CDC. Antibiotic Resistance Threats in the United States, 2013. 16 September 2013.
W
hen you feel sick, you want to feel better fast. But antibiotics aren’t the answer for every illness. This brochure can help you know when antibiotics work – and when they won’t. For more information, talk to your healthcare
provider or visit www.cdc.gov/getsmart.
The Risk:
Bacteria Become Resistant
What’s the harm in taking antibiotics
anytime? Using antibiotics when they are
not needed causes some bacteria to become
resistant to the antibiotic.
These resistant bacteria are stronger and
harder to kill. They can stay in your body and
can cause severe illnesses that cannot be cured
with antibiotics. A cure for resistant bacteria
may require stronger treatment – and possibly
a stay in the hospital.
To avoid the threat of antibiotic-resistant
infections, the Centers for Disease Control
and Prevention (CDC) recommends that
you avoid taking unnecessary
antibiotics.
Antibiotics Aren’t Always
the Answer
Most illnesses are caused by two kinds of
germs: bacteria or viruses. Antibiotics can
cure bacterial infections – not viral infections.
Bacteria cause strep throat, some pneumonia
and sinus infections. Antibiotics can work.
Viruses cause the common cold, most
coughs and the flu. Antibiotics don’t work.
Using antibiotics for a virus:
• Will NOT cure the infection
• Will NOT help you feel better
• Will NOT keep others from catching your illness
Protect Yourself
With the Best Care
Y
ou should not use antibiotics to treat the
common cold or the flu.
If antibiotics are prescribed for you to treat
a bacterial infection – such as strep throat – be
sure to take all of the medicine. Only using
part of the prescription means that only part of
the infection has been treated. Not finishing
the medicine can cause resistant bacteria to
develop.
Talk to Your Healthcare
Provider to Learn More
?
Commonly Asked
Questions:
How Do I Know if I Have a
Viral or Bacterial Infection?
Ask your healthcare provider and follow his or
her advice on what to do about your illness.
Remember, colds are caused by viruses and
should not be treated with antibiotics.
Won’t an Antibiotic Help Me Feel
Better Quicker so That I Can Get
Back to Work When I Get a Cold
or the Flu?
No, antibiotics do nothing to help a viral
illness. They will not help you feel better
sooner. Ask your healthcare provider what
other treatments are available to treat your
symptoms.
If Mucus from the Nose
Changes from Clear to Yellow or
Green — Does This Mean
I Need an Antibiotic?
No. Yellow or green mucus does not mean that
you have a bacterial infection. It is normal for
mucus to get thick and change color during a
viral cold.
GET SMART…
•Antibiotics are strong medicines,
but they don’t cure everything.
•When not used correctly, antibiotics can actually be harmful to your health.
•Antibiotics can cure most bacterial infections. Antibiotics cannot cure viral illnesses.
•Antibiotics kill bacteria – not viruses.
•When you are sick, antibiotics are not always the answer.
USE ANTIBIOTICS WISELY
Talk with your healthcare provider
about the right medicines
for your health.
Cold or Flu.
Antibiotics Don’t
Work for You.
For more information, see the Centers for
Disease Control and Prevention website at:
www.cdc.gov/getsmart or call 1-800-CDC-INFO
A GUIDE FOR PARENTS QUESTIONS AND ANSWERS
Fluid in the Middle Ear (Otitis Media with Effusion)
A
healthcare provider said your child has fluid in
the middle ear, also called otitis (oh-TIE-Tus)
media with effusion (uh-FEW-zhun) (OME).
Fluid usually does not bother children, and it almost
always goes away on its own. This does not have to be
treated with antibiotics, unless it lasts for a few months.
Here are some facts about OME and ear infections.
What are the main kinds of ear
infections?
• S wimmer’s ear (otitis externa) is an infection of the
ear canal that can be painful and is treated with
eardrops.
• A middle ear infection, which a healthcare
provider might call “acute otitis media” (AOM),
may cause ear pain, fever, or an inflamed eardrum,
and is often treated with oral antibiotics.
What causes OME?
Fluid may build up in the middle ear for two reasons.
When a child has a cold, the middle ear makes fluid
just as the nose does – it just doesn’t run out as easily
from the middle ear. After a middle ear infection,
fluid may take a month or longer to go away.
Are antibiotics ever needed
for OME?
Sometimes antibiotics may be needed if the fluid is
still present after a few months and is causing
decreased hearing in both ears. For this reason, your
child will need an ear check in a few months. If there
is still fluid in the middle ear, your child may need a
hearing test.
What should I do?
• T
he best treatment is to wait and watch your child. Since fluid in the middle ear rarely bothers
children, it is best to let it go away on its own.
Right now, your child does not need antibiotics.
• Y
ou may need to schedule a visit to see the
healthcare provider again in a few months to be
sure the fluid is gone.
Why not try antibiotics now?
Taking antibiotics when they are not needed can be
harmful. Each time people take antibiotics, they are
more likely to carry resistant germs in their noses and
throats. These resistant germs cannot be killed by
common antibiotics. Your child may need more costly
antibiotics, antibiotics given by a needle, or may even
need to be in the hospital to get antibiotics. Since
OME will almost always get better on its own, it is
better to wait and take antibiotics only when they are
needed.
1-800-CDC-INFO
www.cdc.gov/getsmart
Is it Really a Penicillin Allergy?
Evaluation and Diagnosis of Penicillin Allergy for Healthcare
Professionals
Did You Know? 5 Facts About Penicillin Allergy
(Type 1, Immunoglobulin E (IgE)-mediated)
1. Approximately 10% of all U.S. patients report having an allergic reaction to a penicillin class antibiotic in their past.
2. However, many patients who report penicillin allergies do not have true IgE-mediated reactions. When evaluated, fewer than
1% of the population are truly allergic to penicillins.1
3. Approximately 80% of patients with IgE-mediated penicillin allergy lose their sensitivity after 10 years.1
4. Broad-spectrum antibiotics are often used as an alternative to penicillins. The use of broad-spectrum antibiotics in patients
labeled “penicillin-allergic” is associated with higher healthcare costs, increased risk for antibiotic resistance, and suboptimal
antibiotic therapy.1
5. Correctly identifying those who are not actually penicillin-allergic can decrease unnecessary use of broad-spectrum antibiotics.1
10% of the population reports a penicillin allergy but <1% of the whole
population is truly allergic.
Before prescribing broad-spectrum antibiotics to a patient thought to be penicillin-allergic, evaluate the patient for
true penicillin allergy (IgE-mediated) by conducting a history and physical, and, when appropriate, a skin test and
challenge dose.
History and Physical Examination
The history and physical examination are important components
when evaluating a patient’s drug reactions.1
•• Questions to ask during the examination:
–– What medication were you taking when the reaction occurred?
–– What kind of reaction occurred?
–– How long ago did the reaction occur?
–– How was the reaction managed?
–– What was the outcome?2
•• Characteristics of an IgE-mediated (Type 1) reaction:
–– Reactions that occur immediately or usually within one hour1
–– Hives: Multiple pink/red raised areas of skin that are intensely itchy3
–– Angioedema: Localized edema without hives affecting the abdomen, face,
extremities, genitalia, oropharynx, or larynx4
–– Wheezing and shortness of breath
–– Anaphylaxis1 requires signs or symptoms in at least two of the following systems:
ƒƒ Skin: Hives, flushing, itching, and/or angioedema (continued on next page)
National Center for Emerging and Zoonotic Infectious Diseases
Division of Healthcare Quality Promotion
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•• Broad-spectrum antibiotics are
often used as an alternative to
narrow-spectrum penicillins.
•• Using broad-spectrum antibiotics
can increase healthcare costs and
antibiotic resistance, and may
mean your patient receives less
than the best care.
•• Correctly identifying if your patient
is actually penicillin-allergic can
decrease these risks by reducing
unnecessary use of broadspectrum antibiotics.
(continued from previous page)
ƒƒ Respiratory: Cough, nasal congestion, shortness of breath, chest tightness, wheeze, sensation of throat closure or choking,
and/or change in voice-quality (laryngeal edema)
ƒƒ Cardiovascular: Hypotension, faintness, tachycardia or less commonly bradycardia, tunnel vision, chest pain, sense of
impending doom, and/or loss of consciousness
ƒƒ Gastrointestinal: Nausea, vomiting, abdominal cramping, and diarrhea5
Penicillin Skin Tests and Challenge Doses
Based on the patient history and physical exam, additional tests may be needed to confirm a penicillin allergy. Penicillin
skin testing is a reliable and useful method for evaluating IgE-mediated penicillin allergy.5
A positive result means the patient is likely to have a penicillin allergy. If negative, the skin test is usually followed by an oral
penicillin class challenge (e.g., with amoxicillin) to safely rule out an IgE-mediated penicillin allergy.1,7
•• Skin tests currently include penicilloylpolylysine, the major antigenic determinant that indicates hypersensitivity
to penicillin.
•• However, it is important to note that the patient can also be allergic to other reactive breakdown products, called minor
determinants, which include penicillin G (benzylpenicillin), penicilloate, and penilloate—many of which are not commercially
available. Of these, only penicillin G is available from pharmacies.
•• To rule out penicillin allergy, an oral challenge dose can be done after skin testing. The negative predictive value of skin testing
with the major and minor determinants is more than 95%, but approaches 100% when followed by a challenge dose.2
Special Considerations
Patients with severe hypersensitivity syndromes
Patients with other severe hypersensitivity syndromes—like Stevens-Johnson syndrome, toxic epidermal necrolysis, serum
sickness, acute interstitial nephritis, hemolytic anemia, and drug rash with eosinophilia and systemic symptoms (DRESS)—should
not use the offending drug in the future. The skin test and challenge described here are not appropriate for patients with these
severe hypersensitivity syndromes.1,2,6
Cephalosporin use in penicillin-allergic patients
Many cephalosporins, especially in the later generations, can be safely tolerated despite a penicillin allergy.6,8 Patients with
anaphylaxis or other severe reactions to penicillin may require further evaluation prior to the use of cephalosporins.
Pediatric patients
Children who are receiving amoxicillin or ampicillin and have Epstein-Barr virus infection can develop a non-allergic, non-pruritic
rash that can appear similar to an IgE-mediated reaction.1,9
For more information about appropriate antibiotic use, visit www.cdc.gov/getsmart.
References
1. Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council
of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273.
2. Gonzalez-Estrada A, Radojicic C. Penicillin allergy: a practical guide for clinicians. Cleve Clin J Med. 2015 May;82(5):295-300.
3. Herrier RN, Apgar DA, Boyce RW, Foster SL. Patient assessment in pharmacy. New York: McGraw-Hill; 2015 [cited 2015 Aug 14]. Available from: http://accesspharmacy.mhmedical.com/
content.aspx?bookid=1074&Sectionid=62364288.
4. Bernstein JA. Update on angioedema: evaluation, diagnosis, and treatment. Allergy Asthma Proc 2011; 32(6):408-412.
5. Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A et al. Second symposium on the definition and management of anaphylaxis: summary report–second
National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med. 2006; 47:373-380.
6. Blumenthal KG, Shenoy ES, Hurwitz S, Varughese CA, Hooper DC, Banerji A. Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical
providers’ antibiotic prescribing knowledge. J Allergy Clin Immunol. 2014;2(4):407-412.
7. Macy E, Ngor E. Recommendations for the management of beta-lactam intolerance. Clinical Rev Allerg Immunol. 2014; 47:46-55.
8. Pichichero, ME. A review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin-allergic patients.
Pediatrics. 2005 Apr; 115(4):1048-1057.
9. Centers for Disease Control and Prevention [Internet]. About Epstein-Barr Virus (EBV) [cited 2015 Aug 17]. Available from: http://www.cdc.gov/epstein-barr/about-ebv.html.
CDC thanks Mina Hong, PharmD Student Class of 2016 at Northeastern University, and Kimberly G. Blumenthal, MD, Division of Rheumatology, Allergy, and Immunology, Department of
Medicine, Massachusetts General Hospital, Harvard Medical School, for their assistance preparing this fact sheet.
Page 2 of 2
Antibiotics are strong medicines. Keep them that
way. Prevent antibiotic resistance. Antibiotics don’t fight
Taking antibiotics for viral infections such
viruses—they fight bacteria. Using antibiotics for viruses can put you at risk of
• Cure the infection
getting a bacterial infection that is resistant to antibiotic treatment. Talk to your
• Keep other people from catching it
healthcare provider about antibiotics, visit www.cdc.gov/getsmart,
• Help you feel better
or call 1-800-CDC-INFO to learn more.
CS121386
as a cold, a cough, or the flu will not:
GET
SMART
About Antibiotics Week
WWW.CDC.GOV/GETSMART
FOR PROVIDERS
PRESERVE THE POWER
OF ANTIBIOTICS
Antibiotic-resistant bacteria cause more than 2 million illnesses and at least 23,000 deaths
each year in the United States. Antibiotic resistance occurs when germs no longer respond to
the drugs designed to kill them. Inappropriate prescribing of antibiotics contributes to antibiotic
resistance and is a threat to patient safety.
Healthcare Providers Can:
•Prescribe correctly
−−Avoid treating viral syndromes with antibiotics, even when
patients ask for them.
−−Pay attention to dose and duration: The right antibiotic
needs to be prescribed at the right dose for the right duration.
−−Be aware of antibiotic-resistance patterns in your area so
that you can always choose the right antibiotic.
−−Hospital and nursing home providers should reassess within 48 hours of
starting the antibiotic, when the patient’s culture results come back. Adjust the
prescription, if necessary. Stop the prescription, if indicated.
•Collaborate with each other and with patients
−−Talk to your patients about appropriate use of antibiotics.
−−Include microbiology cultures, when possible, when ordering antibiotics.
−−Work with pharmacists to ensure appropriate antibiotic use and prevent
resistance and adverse events.
−−Use patient and provider resources offered by the Centers for Disease
Control and Prevention (CDC) and professional organizations such as Society for
Healthcare Epidemiology.
♦♦ Provider Resources: http://www.cdc.gov/getsmart/
♦♦ Patient Resources:
http://www.cdc.gov/getsmart/community/for-patients/index.html
♦♦ General Information:
http://www.cdc.gov/drugresistance/protecting_yourself_family.html
•Stop the spread
−−Follow hand hygiene and other infection control measures with
every patient.
•Embrace antibiotic stewardship
−−Improve antibiotic use in all facilities—regardless of size—through
stewardship interventions and programs, which will improve individual
patient outcomes, reduce the overall burden of antibiotic resistance, and save
healthcare dollars.
−−Recognize and participate in CDC’s Get Smart About Antibiotics
Week initiatives.
CS260605A2
Inpatient Settings
•Overuse of antibiotics creates an unnecessary risk for adverse
drug events, such as Clostridium difficile infection, a sometimes
deadly diarrhea.
•Antibiotic resistance adversely impacts the health of millions of
hospitalized patients every year.
•Some infections in hospitals are now resistant to all available antibiotics.
•About 40% of the patients receiving antibiotics receive unnecessary
or inappropriate therapy.
Outpatient Settings
•Each year, millions of antibiotics are prescribed unnecessarily for
viral infections.
•Antibiotics can cause adverse drug events and promote
antibiotic resistance.
−−There are more Clostridium difficile infections in places with more
antibiotic use.
−−Antibiotic use in primary care is associated with antibiotic resistance
at the individual patient level.
•Antibiotics cause 1 in 5 emergency department visits for adverse drug
events and are the most common cause of emergency department visits
for adverse drug events in children.
For more information, visit CDC’s Get Smart program website:
Get Smart Resources for Healthcare Providers
http://www.cdc.gov/getsmart/week/educational-resources/hcp.html
Centers for Disease Control and Prevention
For more information, please contact Centers for Disease Control and Prevention.
1600 Clifton Road N.E., Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-63548
Email: [email protected] Web: www.cdc.gov/getsmart
A GUIDE FOR PARENTS QUESTIONS AND ANSWERS
Runny Nose (with green or yellow mucus)
Y
our child has a runny nose. This is a
normal part of what happens during the
common cold and as it gets better. Here are
some facts about colds and runny noses.
What causes a runny nose during
a cold?
When germs that cause colds first infect the nose
and sinuses, the nose makes clear mucus. This
helps wash the germs from the nose and sinuses.
After two or three days, the body’s immune cells
fight back, changing the mucus to a white or
yellow color. As the bacteria that live in the nose
grow back, they may also be found in the mucus,
which changes the mucus to a greenish color.
This is normal and does not mean your child
needs an antibiotic.
Are antibiotics ever needed for a
runny nose?
Antibiotics are needed only if your healthcare
provider tells you that your child has sinusitis.
Your child’s healthcare provider may prescribe
other medicine or give you tips to help with a
cold’s other symptoms like fever and cough, but
antibiotics are not needed to treat the runny
nose.
Why not try antibiotics now?
What should I do?
• T
he best treatment is to wait and watch your
child. Runny nose, cough, and symptoms
like fever, headache, and muscle aches may be
bothersome, but antibiotics will not make
them go away any faster.
• S ome people find that using a cool mist
vaporizer or saltwater nose drops makes their
child feel better.
Taking antibiotics when they are not needed can
be harmful. Each time people take antibiotics,
they are more likely to carry resistant germs in
their noses and throats. These resistant germs
cannot be killed by common antibiotics. Your
child may need more costly antibiotics,
antibiotics given by a needle, or may even need
to be in the hospital to get antibiotics. Since a
runny nose almost always gets better on its own,
it is better to wait and take antibiotics only when
they are needed.
1-800-CDC-INFO
www.cdc.gov/getsmart
GET
SMART
SAVE MONEY WITH
ANTIBIOTIC STEWARDSHIP
About Antibiotics Week
WWW.CDC.GOV/GETSMART
Antibiotic stewardship programs and interventions help ensure that patients get the right
antibiotics at the right time for the right duration. Numerous studies have shown that
RETURN ON INVESTMENT
implementing an antibiotic stewardship program can not only save lives, but can save
significant healthcare dollars. Inpatient antibiotic stewardship programs have consistently
demonstrated annual savings to hospitals and other healthcare facilities of $200,000
to $400,000.
Antibiotic stewardship in your facility will:
Increase good patient outcomes
Decrease antibiotic resistance
Did You Know?
1. Antibiotic resistance is one
of the world’s most pressing
public health threats.
2. Antibiotic overuse increases
the development of drugresistant germs.
3. Antibiotics are the most
important tool we have to
combat life-threatening
bacterial diseases, but
antibiotics can have
side effects.
4. Patients, healthcare providers,
hospital administrators, and
policy makers must work
together to use effective
strategies for improving
antibiotic use—ultimately
improving medical care and
saving lives.
CS267085
Decrease C. difficile infections
Decrease costs
• According to a University of Maryland study, implementation of one antibiotic stewardship
program saved a total of $17 million in a span of seven years at one institution.
After the program was discontinued, antibiotic costs increased by more than one million
dollars in the first year (an increase of 32 percent) and continued to increase the
following year.
• In a study conducted at The Johns Hopkins Hospital, it was demonstrated that guidelines
for management of community-acquired pneumonia could promote the use of shorter
courses of therapy, saving money and promoting patient safety.
• Targeting certain infections may decrease antibiotic use. For example, determining
when and how to treat patients for urinary tract infections, the second most common
bacterial infection leading to hospitalization, can lead to improved patient outcomes and
cost savings.
Why We Must Act Now
• The way we use antibiotics today or in one patient directly impacts how effective they will be tomorrow or in another patient; they
are a shared resource.
• Antibiotic resistance is not just a problem for the person with the infection. Some resistant bacteria have the potential to spread to
others—promoting antibiotic-resistant infections.
• Since it will be many years before new antibiotics are available to treat some resistant infections, we need to improve the use of
antibiotics that are currently available.
Healthcare Facility Administrators and Payers
• Make appropriate antibiotic use a quality improvement and
patient safety priority.
• Focus on reducing unnecessary antibiotic use, which can reduce
antibiotic-resistant infections, Clostridium difficile infections, and
costs, while improving patient outcomes.
• Emphasize and implement antibiotic stewardship programs and
interventions for every facility—regardless of facility setting
and size.
• Monitor Healthcare Effectiveness Data and Information Set (HEDIS®)
performance measures on pharyngitis, upper respiratory infections,
acute bronchitis, and antibiotic utilization.
For more information, visit CDC’s Get Smart program website:
Get Smart Resources for Healthcare Providers
http://www.cdc.gov/getsmart/week/educational-resources/hcp.html
Centers for Disease Control and Prevention
For more information, please contact Centers for Disease Control and Prevention.
1600 Clifton Road N.E., Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-63548
Email: [email protected] Web: http://www.cdc.gov/getsmart
W
hen your child is sick, you want to
do everything you can to help. But
antibiotics are not the answer for
every illness. This brochure will help you
know when antibiotics work – and when they
won’t. For more information, talk to your
healthcare provider or visit www.cdc.gov/
getsmart.
The Risk:
Bacteria Become Resistant
What’s the harm in giving your child
antibiotics anytime? Taking antibiotics when
they are not needed can cause some bacteria
to become resistant to the antibiotic.
These resistant bacteria are stronger and
harder to kill. They can stay in your child’s
body and can cause severe illnesses that can’t
be cured with antibiotics. A cure for resistant
bacteria may require stronger treatment – and
possibly a stay in the hospital.
To help prevent antibiotic resistance, the
Centers for Disease Control and Prevention
(CDC) recommends giving your child
antibiotics only when necessary.
Antibiotics Aren’t Always
the Answer
Most illnesses are caused by two kinds of
germs: bacteria or viruses. Antibiotics can cure
bacterial infections – not viral infections.
Bacteria cause strep throat, some pneumonia
and sinus infections. Antibiotics can work.
Viruses cause the common cold, most
coughs and the flu. Antibiotics don’t work.
Using antibiotics for a virus:
• Will NOT cure the infection
• Will NOT help your child feel better
• Will NOT keep others from catching your child’s illness
Protect Your Child,
Give the Best Care
A
ntibiotics should not be used to treat
the common cold, runny noses and
most coughs. Children fight off these
viral illnesses on their own.
If your child’s healthcare provider prescribes
an antibiotic to treat a bacterial infection –
like strep throat – be sure to give your child all
of the medicine. Only using part of the prescription means that only part of the infection
has been treated. Not finishing the medicine
can cause resistant bacteria to develop.
Talk to Your Healthcare
Provider to Learn More
?
Commonly Asked
Questions:
How Do I Know if My Child has
a Viral or Bacterial Infection?
Ask your child’s healthcare provider and follow
his or her advice on what to do about your
child’s illness.
Remember, colds are caused by viruses and
should not be treated with antibiotics.
Does This Mean I Should Never
Give My Child Antibiotics?
Antibiotics are very strong medicines and
should be used to treat bacterial infections. Your
healthcare provider will prescribe antibiotics if
your child has a bacterial infection.
If Mucus from the Nose Changes
from Clear to Yellow or Green —
Does This Mean That my Child
Needs an Antibiotic?
No. Yellow or green mucus does not mean that
your child has a bacterial infection. It is normal
for mucus to get thick and change color during
a viral cold.
FOR PARENTS
GET SMART…
•Antibiotics are strong medicines,
but they don’t cure everything.
•When not used correctly, antibiotics can actually be harmful to your
child’s health.
•Antibiotics can cure most bacterial infections. Antibiotics cannot cure viral illnesses.
•Antibiotics kill bacteria – not viruses.
•When your child is sick, antibiotics are not always the answer.
USE ANTIBIOTICS WISELY
Talk with your healthcare
provider about the right medicines
for your child's health.
Snort. Sniffle.
Sneeze.
No Antibiotics
Please.
For more information, see the Centers for
Disease Control and Prevention website at:
www.cdc.gov/getsmart or call 1-800-CDC-INFO
Treat colds and flu with care.
Talk to your healthcare provider.
As a parent, you want to help your child feel better. But antibiotics
aren’t always the answer. They don’t fight the viruses that cause
colds and flu. What will? Fluids and plenty of rest are best. Talk to
your healthcare provider. Find out when antibiotics work—and
when they don’t. The best care is the right care.
For more information, please call 1-800-CDC-INFO
or visit www.cdc.gov/getsmart.
CS121386
Treat colds and flu with care.
Talk to your healthcare provider.
As a parent, you want to help your child feel better. But antibiotics
aren’t always the answer. They don’t fight the viruses that cause
colds and flu. What will? Fluids and plenty of rest are best. Talk to
your healthcare provider. Find out when antibiotics work—and
when they don’t. The best care is the right care.
For more information, please call 1-800-CDC-INFO
or visit www.cdc.gov/getsmart.
CS121386
Viruses or Bacteria
What's got you sick?
Antibiotics only treat bacterial infections. Viral illnesses cannot be treated with
antibiotics. When an antibiotic is not prescribed, ask your healthcare professional
for tips on how to relieve symptoms and feel better.
Illness
Usual Cause
Antibiotic
Viruses Bacteria Needed
Cold/Runny Nose
NO
Bronchitis/Chest Cold (in otherwise healthy children and adults)
NO
Whooping Cough
Yes
Flu
NO
Strep Throat
Yes
Sore Throat (except strep)
NO
Fluid in the Middle Ear (otitis media with effusion)
NO
Urinary Tract Infection
Yes
Antibiotics Aren’t Always the Answer
www.cdc.gov/getsmart
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Sept 2014