Flu or Flu-like illness in chronically ill or disabled children
Parents views on the benefits of antibiotics
Children with a long term medical condition or disability may develop bacterial infections, such as chest infections and ear infections, when they have flu or flu-like illness. Antibiotics can be very effective to treat these bacterial infections. Parents were often aware of wider concerns about antibiotic resistant infections (see ‘Parents concerns about taking antibiotics’) and knew that antibiotics were not effective in treating viruses. However, having a child with a long term medical condition or disability meant they were willing to accept an antibiotic to prevent their child becoming seriously ill when they had flu or flu-like illness.
Some parents we spoke to said that making the decision to give their child antibiotics was sometimes “a difficult decision to make.” But mostly parents accepted that their children needed to take antibiotics when they had flu or flu-like illness and any concerns they had about taking them were outweighed by wanting their child to be well again.
Harriet has never questioned the need to give Alfie antibiotics. She believes they have been crucial to his well- being and prevent him from developing complications.
Harriet has never questioned the need to give Alfie antibiotics. She believes they have been crucial to his well- being and prevent him from developing complications.
I’ve always had the opinion that because leukaemia is a serious illness. I’m very open to antibiotics. I think that they should be given as early as possible in my opinion because I know, I know from my rudimentary knowledge of medicine that it, they can something like the flu can lead to something much more serious in a childlike Alfie. And I know of other children that have had things develop into pneumonia and other illnesses which are worse I don’t know if flu directly can be, you know, what I mean, like I think that it’s really important to give, I’d never question them giving antibiotics even though I know that you should limit the amount a person, one has of antibiotics. I know that you shouldn’t just take them willy-nilly but, and I’ve always been very careful about completing courses and giving them the right dosages, the right times and try to be as conscious, conscientious as I can be about take, giving them correctly when I’m giving them from home. But I know other parents that have, that are resistant to giving antibiotics and would rather limit them as much as possible. But I think for Alfie it’s important that he’s given them, if he needs them then we, he should have them like immed, as quickly as possible.Mirella says that her son needed to have antibiotics to treat his infection and he would not have got better without it.
Mirella says that her son needed to have antibiotics to treat his infection and he would not have got better without it.
And I guess you know, why my older son, different medical issues than to wheeziness, but he for his first two years pretty much had a course of antibiotics every day, not every day, every month. So yeah so he got prescribed pretty much once a month antibiotics. But then I did appreciate that he needed it. So yes he might have built up a bit of a tolerance but then again you know his condition would have not got better without it, so although I was concerned a little bit I still gave the antibiotics to him because obviously they needed it so.Michael says the benefits of treating Ella with antibiotics early is it ‘nips it in the bud’ and takes less time for her to bounce back.
Michael says the benefits of treating Ella with antibiotics early is it ‘nips it in the bud’ and takes less time for her to bounce back.
I mean, I haven't.
Or what do you think?
I haven't, I haven't. Because you hear people saying that obviously if you have too many antibiotics, when you do get an illness they're not as effective. But in the other hand, [sigh] when you see your child there that's poorly, and needs the antibiotics to make them better, then how can you not say "don't give them?" You know? So yes, I have concerns if doctors were just giving them out willy-nilly. But even if they wasn't really following it up that they had flu-like symptoms, if someone just went in and they'd got a bit of a sort of a temperature that wasn't that high, but then decided 'oh, we'll just give them antibiotics just to cover us'. Yeah, that's probably not the way to go. But at the same time, obviously you want to be sure that you're not missing anything, and obviously the antibiotics would, would nip it in the bud if you caught it that bit earlier. And that, I think that's, that's the key with Ella. The slightest symptom, and the first sign that we get that she's not right, if we can get her on the antibiotics, it takes a lot less time for her to bounce back from it than what it would be that if we let her sort of carry on with it for a day, three days to a week. The longer it'd go on, the longer it would take for the antibiotics to work, and get her over it. Whereas if we was on the ball and we, we noticed her symptoms fairly quick, within a day, and we got the antibiotics started straight away, generally within, within the week - as I say, three days of being on them, you notice a difference.On one occasion, Nia felt antibiotics should have been prescribed early to prevent her son developing pneumonia.
On one occasion, Nia felt antibiotics should have been prescribed early to prevent her son developing pneumonia.
Okay.
So on the last occasion I mentioned in July of this year my son ended up with another episode of pneumonia, we saw the nurse practitioner for the first consultation. She prescribed steroids but not antibiotics and we went away, you had three or four days at home, getting steadily worse, more and more lethargic, more and more mucous, more you know more generally unwell. We then went back to see the GP who agreed that actually he needed antibiotics in addition to the steroids and I felt that perhaps that should have been done on the first occasion, knowing his history. And obviously the nurse practitioner didn’t know the history. But then again I understand that she’s been advised not to give antibiotics unless she feels they are strictly necessary.Each time Arthur is poorly, Sarah tries to assess the nature of the illness to see if he would benefit from having antibiotics.
Each time Arthur is poorly, Sarah tries to assess the nature of the illness to see if he would benefit from having antibiotics.
Yeah, and he was just touching his ear a lot. So we kind of - again, it was a heavy, heavy cold. We assumed, we left it. I think with the earache I actually went, that was one of my earlier visits to the doctors. So I kind of took him, because he was touching his ear so much, we took him - I took him to the doctors, I think it was on the first day. But they said they couldn't see anything. And then when I did go back after the 48 hours, apparently it was obvious. So, which could have got worse, it could have got worse over the 48 hours - it might not have been obvious on the first visit. But, but I think when you take a child, especially a non-verbal child, to the doctors and they are constantly touching something, as a mother my opinion is that there's something wrong. And especially with a maybe, I think that, that is probably one of the times that they could have prescribed an antibiotic, maybe.Hyacinth thinks an assessment of each flu-like illness episode is needed before treating her son early with antibiotics.
Hyacinth thinks an assessment of each flu-like illness episode is needed before treating her son early with antibiotics.
That’s right.
But because they thought it was a virus they held out and he never got antibiotics, and the chest infection became worse and worse, so they were, that time I, if I had the option of early you know preventative antibiotics I would have taken it. So I think each case is kind of different and I can’t, yeah. I can’t make that kind of blanket statement.Each time Arthur is poorly, Sarah tries to assess the nature of the illness to see if he would benefit from having antibiotics.
Each time Arthur is poorly, Sarah tries to assess the nature of the illness to see if he would benefit from having antibiotics.
Yeah, and he was just touching his ear a lot. So we kind of - again, it was a heavy, heavy cold. We assumed, we left it. I think with the earache I actually went, that was one of my earlier visits to the doctors. So I kind of took him, because he was touching his ear so much, we took him - I took him to the doctors, I think it was on the first day. But they said they couldn't see anything. And then when I did go back after the 48 hours, apparently it was obvious. So, which could have got worse, it could have got worse over the 48 hours - it might not have been obvious on the first visit. But, but I think when you take a child, especially a non-verbal child, to the doctors and they are constantly touching something, as a mother my opinion is that there's something wrong. And especially with a maybe, I think that, that is probably one of the times that they could have prescribed an antibiotic, maybe.Harriet has a very different approach to Alfie and his younger brother taking antibiotics when they have flu or flu-like illness.
Harriet has a very different approach to Alfie and his younger brother taking antibiotics when they have flu or flu-like illness.
Some children took a low dose of antibiotic every day to prevent bacterial infections. This is known as antibiotic prophylaxis. Parents of these children said they had seen an improvement in their children’s health.
Taking a low dose of antibiotic has worked well for Meg, who has interstitial lung disease. Her mum says she no longer needs to panic and watch her all the time when she has flu-like illness.
Taking a low dose of antibiotic has worked well for Meg, who has interstitial lung disease. Her mum says she no longer needs to panic and watch her all the time when she has flu-like illness.
Oh okay.
That’s made a huge difference.
How long has she been on that now? When did they start it?
She was seven months.
And how was that decision, how did that come about?
The doctor we saw privately advised us to go on Azithromycin because all their lung children were on it, specifically during the winter months. They would prefer them to be off it in the summer, now some children cope with that, and some children don’t.
Because Meg had such a severe pneumonia episode they decided initially to put her on two mls a day and she was on that for three months.
Okay.
And then we went onto it, just to get us over the winter, and then we went onto it Spring/Summer three times a week. And we’ll continue on that throughout this winter and see how she fares.
Sorry the question you asked, oh what are my concerns, pros and cons?
Yeah, pros and cons for her now.
This is a topic that comes up quite frequently amongst us parents, or mothers and fathers whose children are on not only antibiotics but also steroids as a form of maintenance and control with lung disease. And there are people who have very strong opinions about antibiotics. I think there’s a, there’s definitely a time and a place for it. I think because of how I grew up I, my natural instinct is to resort to an antibiotic, I have seen how well it has worked for Meg and the difference it’s made to our lives. I don’t feel stressed out any more about her illness, I don’t feel like I need to panic and watch her all the time. In the back of my mind I know she’s on something that if there’s a bacterial infection in her lungs she’s going to be okay. I’m probably not going to land up in hospital with it. So it’s, I'm sure that there are cons to it, I haven’t looked into it too deeply, mostly because I think she has improved so much I’m hoping that she won’t need it in the long term.
Some parents did not see the need to give their children antibiotics as a preventative treatment but would accept them on a case by case episode of flu-like illness. Jo said that when her daughter, Evie, was very young she was put on antibiotics as a ‘precaution’ but that she no longer needs that treatment now she is four years old.
See ‘What are antibiotics and why are they used (or not) in children with flu-like illness - A doctor speaks’, ‘Parents concerns about taking antibiotics’, ‘Side effects of antibiotics’.
Copyright © 2024 University of Oxford. All rights reserved.