Summary: Doctors should take a wait-and-see approach before prescribing an antibiotic to treat acute bacterial sinus infections in children. The American Academy of Pediatrics recommends giving it 13 days to clear up on its own before relying on drugs.
The American Academy of Pediatrics (AAP) issued new guidelinesfor the treatment of sinus infections in children, ages 1 to 18. The new recommendation is to wait 13 days after an acute bacterial sinus infection is detected, to allow it to clear up on its own, before prescribing antibiotics. In the past, the AAP guideline indicated a 10-day waiting period before antibiotic use was recommended.
Colds are especially “common” among children. Most kids under age 3 catch at least eight colds a year, because of their still-developing immune systems. The common children’s cold is a viral infection of the upper respiratory tract that usually lasts a week or two. Antibiotics are not used to treat a cold. But sometimes even after the cold is gone, the swollen sinus cavities remain, and the openings that normally allow the sinuses to drain into the back of the nose get blocked, sinuses fill with fluid, and bacteria get trapped inside and grow there. This is bacterial sinusitis, and in the past, antibiotics were readily administered to get rid of it.
But now the question of when to ask your pediatrician to prescribe antibiotics for your sick child is one that nags at most parents. On the one hand, we hear that the over-prescribing of the drugs to an individual can create a resistance to the drug so that stronger and stronger drugs will be needed to fight even mild bacterial infections. Overuse is also a factor in the emergence of superbugs that are resistant to antibiotics altogether. Still, parents don’t want to see their child suffer needlessly.
To address this concern, the AAP revised its guideline. In contrast to the 2001 guideline, which recommended antibiotic therapy for all children diagnosed with acute bacterial sinusitis, the 2013 guideline allow doctors to observe children with persistent illness lasting more than 10 days for an additional three days. Children with severe or worsening symptoms should receive antibiotics. First-line treatment is amoxicillin, which may be switched to another antibiotic if symptoms worsen or do not improve after 72 hours.
How do you handle cold symptoms? Do you avoid using antibiotics?
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