Why Don't Antibiotics Work Anymore?

More About Antibiotic Resistance

If a regular dose of amoxicillin doesn't work for your child's sinus infection or if your child is in day care, the AAP recommends using high dose amoxicillin-clavulanate (Augmentin ES), or as an alternative, cefdinir (Omnicef), cefuroxime (Ceftin), or cefpodoxime (Vantin). If your child is vomiting a lot, a single dose (shot) of ceftriaxone (Rocephin) may be given. If amoxicillin doesn't work, the AAP recommends against using antibiotics like trimethoprim-sulfamethoxazole (Bactrim) and erythromycin-sulfisoxazole (Pediazole), sine they will likely not be effective because of high resistance to them.

So if your child has been prescribed an antibiotic and isn't getting better, you might first go back to your doctor for a recheck and to confirm that he has a bacterial infection that needs antibiotics to get better, and then that he has been prescribed one of the antibiotics in the above guidelines, such as Amoxil (either regular or high dose), Augmentin ES, Omnicef, Ceftin, Vantin, and Rocephin. If a different antibiotic is being used, you might ask why. There may be a good reason why your Pediatrician has chosen a different antibiotic, but if you are not satisfied with the answer, you might ask to be prescribed one of the antibiotics recommended above.

Some facts about these antibiotics:

• amoxicillin (Amoxil) can now be used just twice a day and comes in many different strengths, including the newer 400mg/teaspoon, 400mg chewable, 875mg tablets, however the newer forms are not generic and may cost a little more.
  
  
• cefuroxime (Ceftin) is not the best tasting medicine and many kids have trouble taking it. To help with the taste, you might ask your pharmacist if they can flavor it (with FlavoRx for example) or dip the teaspoon into some chocolate syrup first. Since the bottom of the teaspoon with the chocolate syrup will touch your child's tongue first, it might hide the taste of the antibiotic.
  
  
• cefdinir (Omnicef) tastes good and can be used just once a day, which is very convenient. It can sometimes turn a child's bowel movements red or orange, which can be confused with blood. It is not a serious problem, just something to watch for. Your Pediatrician can test your child's stool to see if it is really blood or not if this does happen.
  
  
• ceftriaxone (Rocephin) is a once a day shot. It might be given just once, or once a day for three days for truly resistant infections.
  
  

• Talk with your health care provider about antibiotic resistance.
• Ask whether an antibiotic is likely to be beneficial for your illness.
• Ask what else you can do to feel better sooner.
• Do not take an antibiotic for a viral infection like a cold or the flu.
• Do not save some of your antibiotic for the next time you get sick.
• Take an antibiotic exactly as the doctor tells you.
• Do not take an antibiotic that is prescribed for someone else.

References:

²Clinical practice guideline: management of sinusitis. - Pediatrics - 01-Sep-2001; 108(3): 798-808

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