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Friday, 8 April 2016

Why I am no longer anti-antibiotic

Duckling is currently taking his fourth round of antibiotics in the space of four months. The first was for a chest infection, the second was a prophylactic course to prevent an infection in his severed fingertip (bit unfortunate that one), and the most recent two have been for another chest infection (the first lot didn't totally clear it, so we're now onto the second).

Much is made of antibiotics being handed out "like Smarties" (though I'm not sure many doctors would advocate the liberal distribution of Smarties either) and how it leads to the emergence of antibiotic resistant bacteria, particularly where patients don't complete their full course. There is also increasing evidence that antibiotics - especially multiple courses taken in the first two years of life - can result in a higher incidence of asthma and eczema in children. The theory goes that they wipe out natural gut flora that have an important role in establishing and regulating the immune system. An unruly immune system can cause overreactions to normally harmless things - such as pollen and dust mites - and thus allergy symptoms. And this is just one impact of antibiotics that we know about - it's possible there are more that haven't been researched quite so fully.

Knowing all this, when I first embarked on motherhood I was quite determined that Duckling would never take antibiotics.  This was clearly a ridiculous aspiration, based on a misguided belief that I would have a child that never got more than a mildly snotty nose.  Two years and four rounds later, I have very much dismounted my high horse.  I realise that nobody takes / administers antibiotics for fun (have you ever tried getting a spoonful of sickly banana gloop into a two year old? Not. Fun.). They do it through necessity - or at least a predicted necessity.  Certainly some prescriptions may turn out to be overkill, but there is often no way of quickly and cost effectively assessing when infections are bacterial, or whether a person's immune system is strong enough to fight an infection on their own. Despite what the floggers of complimentary medicines might like to tell you, antibiotics, when taken for the right thing, do work, and work well. They have revolutionised modern medicine. They are not perfect - no effective medicine is 100% side effect free - but faced with a choice of amputation / death, or antibiotics, I'll take the latter thanks.

When faced with the choice between a doctor's visit with a mildly wheezy Duckling or a critical meeting at work, there wasn't any real decision to be made either (I'll save the story of how he demanded 'boobie' in the middle of my hastily arranged conference call for another day - though I will say passing it off as a request for 'blueberries' was a minor stroke of genius). The doctor listened to his chest, frowned a lot, then packed us off with a prescription for a new inhaler and some amoxicillin. Fourty-eight hours later some steroid tablets were added to the mix ('roid rage is such a joy in an already tantrum prone tot), followed by stronger antibiotics, a steroid inhaler and a chest x-ray at the start of this week.  I'll be honest, there was a moment at the beginning where I wondered if I'd encountered a Smarties peddler who was making a fuss about nothing, and whether I should just leave Duckling to fight things himself. A trip round Sainsbury's where he coughed so much he was sick quickly changed my mind though.  There is a fine line between laid back parenting and neglect.

I'd love a super healthy child who sails through life with only the occasional cold and a bit of mild puking, but despite two years of breastfeeding, and plenty of fresh air and soil eating, I don't have one of those. Maybe I will in the future when he's built up his immunity fully, but for now I have to accept he's a little bit vulnerable and balance the risks - not demanding antibiotics at the first sign of a sniffle, but not ignoring the developing wheeze either. Yes, he may have a higher risk of asthma with all this antibacterial bombing, but I'd say there's a real chance that asthma is what's making him need the antibiotics in the first place, so withholding them just seems a bit perverse.  I know there is a wider problem to society of antibiotic resistance, and that there is a chance his illness was just viral and would have gone away of its own accord.  I am not willing to risk my child's immediate health for either reason though.  For Duckling, this time, antibiotics seem to have kept him out of hospital, and for that I am very grateful. I am over my antibiotic snobbery. I just hope we still have some effective ones available by the time Duckling has his own kids (and to help ensure that, I will make sure he finishes the course, I promise).

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