Natalie Lambajian-Drummond, M.D.

When the cold and flu season occurs in northern Illinois, many pediatricians are faced with weary parents who feel as if their child has been sick too long and head for the doctor's office desperately seeking a "cure." Runny noses, coughs, intermittent low- grade fevers, fatigue, irritability, and poor appetite are just a few symptoms on a long list they describe.

Unfortunately, some parents are not so thrilled to hear that there is no "cure" for the common cold, and that the symptoms their children are experiencing are due to a myriad of viruses plaguing the community at the time - viruses that are unaffected by any amount of antibiotic a doctor could give them.

Viruses, by far, cause the majority of upper respiratory infections (URI). They invade the body through the mouth, nose or eyes and are transmitted from person to person by respiratory droplets or direct touch. Viruses are very hearty and are easily passed between people in groups, making schools and day care centers excellent environments for transmission.

Once a person has contracted a virus, the body turns to its natural defenses to recognize infected cells and kill them. It is the body's response to infection that causes the symptoms that make us feel miserable, not the infection itself. For example, mucous production forms an additional barrier to block viruses from invading deeper, and a cough provides burst of air keeping viruses from moving into the lungs or to help move mucous that has formed out of the lungs to clear infection. In most cases, the body does an effective job of clearing infection in about a week to ten days, but since each virus is unique and can spark a host of new symptoms, it can seem like your child is continually sick. The average child has six to ten upper respiratory infections per year with the greatest concentration between November and March.

Some children with upper respiratory infections, however, develop secondary bacterial infections, the three most common being ear infections, sinus infections and pneumonia. In these cases, an antibiotic is beneficial. Symptoms of bacterial infection include a fever, usually greater than 102 degrees and lasting more than 3 days, and pain in the ear, face or chest. If symptoms persist beyond 14 days without a symptom-free period, please take your child to your pediatrician for an evaluation.

If your child is prescribed an antibiotic, symptoms generally improve within three days. Even with improvement, it is important to take the entire course of the antibiotic prescribed. Stopping the use of an antibiotic early can cause relapse and leave your child with a worse infection that may require a new and sometime stronger antibiotic. If there is no improvement, the antibiotic may not be effective, which is being observed more frequently in an age of antibiotic resistance caused by inappropriate antibiotic use.

In this age of antibiotic resistance, physicians have a responsibility to prevent the development of resistant organisms by being cautious in prescribing antibiotics. The Centers for Disease Control and many states, including Illinois, have initiatives to curb unnecessary antibiotic use. These strict guidelines are intended to protect future generations from infections for which there is no effective antibiotic. Current studies have shown that resistance rates for some of the most common antibiotics increased 300-1000% over a five-year period. Pressure from patients, or parents, was often cited as the most common reason an antibiotic was prescribed. Always keep in mind that sometimes the best medicine is no medicine at all.