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Antibiotics And Children

A very important issue concerning the children of today is the excess prescribing of antibiotics and the dangers that are being created. Everyday, more and more children are being prescribed any easy solution to a very tough problem. There is a constant push from pharmaceutical companies, parents, and massive marketing companies to try the next antibiotic remedy, but as we look towards the future and the diseases that can be created by this quick fix, we should turn to our attention to alternatives remedies.

What is so terrible about this situation is that the worst-case scenario of the effects of the mass doses of antibiotics they ingest is an untreatable bacterium that is immune to the treatments we are aware of. That may not sound so bad until you think about the number of children around the world that could die from this bacterium. It would most definitely be a catastrophic event if a portion of the earth’s population at that early of an age were to be erased. It would be a human-induced bubonic plague of the twenty-first century and it is really not that far from becoming a reality.

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In a study done in 1992, there were over sixty million different oral antibiotic prescriptions were giving to people under the age of fifteen years old (Napoli). The extensiveness of antibiotic options coupled with their widespread use in pediatric patients highlight the importance of pharmacists having a thorough familiarity with pediatric antibiotic therapy. Also, problems may arise in treating children under the age of two because of their immature immune system, lack of Food and Drug Administration (FDA) approval for pediatric use of many antibiotics and limited data supporting therapy courses of less than ten days (Napoli). Also, an added complication of the treatment of the patient is the willingness, ability to follow the regimen, and the understanding of the importance of completing the therapy.

Before filling the prescription for the appropriate medication, physicians need to be aware of common pediatric infections and their recommended antibiotic therapy. It is important to remember that most upper respiratory infections are viral and that antibiotics would be futile in the attempt to treat such an infection (Berger). This will only strengthen the resistance of bacterial pathogens, limiting the efficacy of the available antibiotic treatments. Common pediatric infections include otitis media (OM), skin and skin-structure infections, pharyngitis, bronchitis and urinary tract infections (UTIs) (Napoli).

Most antibiotic prescriptions that are issued each year go to children under the age of six. This is also the age group that is most susceptible to the high-resistance strain of bacteria (Drugs and Biotech). Recently, bacteria that commonly infect children and adults (like streptococcus pneumonia and staph) have become progressively resistant to antibiotics (Napoli). Widespread, indiscriminate use of antibiotics has created highly resistant bacteria. Some children who could normally be treated with a single course of antibiotics have to be treated with two or more courses. Some who could have been previously treated with an oral antibiotic at home now have to be admitted to hospitals and treated with intravenous antibiotics (More Drugs ?).

Infections with antibiotic resistant bacteria are much more common in high income, white, suburban children under the age of 6, who have received an antibiotic in the last three months and attend childcare (More Drugs ?). These children are much more likely to visit their doctor and are at greater risk of receiving an antibiotic than populations that are medically underserved (Drugs and Biotech).

As stated before, antibiotics are effective only in bacterial infections and not in viral infections. If you take one hundred children with a fever, on average ninety of them will have a viral infection and ten of them a bacterial one (Berger). Unfortunately, antibiotics will do nothing to lessen the symptoms or to hasten the resolution of the viral infections. The problem could be easily solved if the doctors would just explain this to the parents instead of letting them push for more and more antibiotics (More Drugs ?).

In fact, studies show that doctors are more likely to prescribe an antibiotic when the parent pushes for that drug. Parents, on the other hand, say that doctors are not taking the time to explain when children need an antibiotic and when they do not (Peterson). Usually, if doctors are willing to take time to explain the differences between viral and bacterial diseases, parents will be more satisfied with the interaction, and children will be spared the harmful effects of unnecessary antibiotics (More Drugs ?).

In response to the arising question that restricting the use of antibiotics increases the risk of a poor outcome or complications, Dr. Roger A.M.J. Damoiseaux of University Medical Center, Utrecht, Netherlands, and colleagues conducted a trial in which half the children were given amoxicillin, the standard, first-choice antibiotic (Berger). The 240 Dutch children who participated ranged in age from six to twenty-four months. They were randomly divided to take either 40mg of amoxicillin in three divided doses or a placebo for ten days (Berger). This was a double-blind study in which neither the doctors nor the parents were aware of the distribution of medication. Both groups were giving the acetaminophen/decongestant treatment, and the parents were instructed to keep a ten-day diary of ear and gastrointestinal symptoms, the common adverse effects of amoxicillin (Berger).

The results showed that amoxicillin did benefit some children; fever, for example, lasted a median of one day less. More painkillers were giving to placebo takers (a mean of 2.5 doses) during the first three days of illness than in the amoxicillin group (a mean of 1.7 doses). Symptoms persisted at day four in 72% of the children taking placebos, as compared to 59% of those on the antibiotic amoxicillin (Berger).

Pfizer has even taken up residence on Sesame Street, pledging to underwrite the 31st season of the popular children’s show. Starting January of the year 2000, Pfizer has been airing fifteen-second ads at the opening and closing of each episode. But, according to Pat Kelley, Pfizer Senior Vice President, the ads are not ?designed to boost sales of antibiotics? (Peterson).

Pfizer, based of out New York, spends more than any other drug company to advertise to consumers, and it’s marketing efforts have garnered warnings from federal regulators and criticism from doctors (Pfizer). In recent months, the complaints have grown, as state and federal officials have blamed aggressive consumer advertising by drug skyrocketing the cost of drugs (Peterson).

Pfizer, the largest drug company in America, was probably the first in the industry to transform itself so clearly from a research-driven company to one that operates more like Proctor and Gamble, the maker of the detergent Tide (Pfizer). At Pfizer and a growing number of other drug companies, marketing executives, not scientists are in charge. At Pfizer, marketing directors work side by side with the scientists, even from the early development stages on. Always monitoring what the profit margin will be and how they will be able to leverage this prescription in the particular market they were looking for (Pfizer).

They have introduced a massive ad campaign one-fifth larger than normal in the industry and have spent nearly 39% of its sixteen billion in revenue on marketing expenses (Peterson). This just goes to show how much these companies are just trying to push their product onto the consumers as if it was in that situation. These are people that are creating medicine. Unlike a product like soap, these are items that are created with the intent to heal a patient, not be sold to a consumer. Pfizer’s brushes aside the concern. In an interview, Mr. Steers said the company’s ads were helping to improve the public’s health, not only by supplying effective drugs to ailing patients, but also by prompting people long reluctant to go to the doctor to set up appointments (Peterson).

Though we are completely aware of the situation that is at hand, we will probably continue to ignore the issue for as long as possible, most likely until it is too late. This is what we do in this country; we ignore the adverse of effects of something and concentrate on what we believe in our minds as the quick fix remedy. Until they is a mass media campaign explaining the dangers of the over prescription of antibiotics, we will continue to raise the immunity of certain bacteria. But, this will never ever happen because it would hurt the pockets of the drug machines that the economy and we rely upon. Unfortunately, that is the case we will have to live with it.



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