Treating children without antibiotics in primary healthcare

The overuse of antibiotics in children is becoming a major public health problem. Although most of the common childhood infections such as diarrhea and upper respiratory tract infections are caused by viruses, large volumes of antibiotics are prescribed for these infections in children in the primary care settings. Excessive use of antibiotics is the fundamental risk factor for the development of antibiotic resistance. It is estimated that 90% of upper respiratory tract infections are self limiting viral illnesses and even bacterial infections like acute otitis media often run a self limiting course. Clinical trials have shown that antibiotic use to treat common upper respiratory tract infections like sore throat, nasopharyngitis and otitis media has no or minimal benefit on the clinical outcome. This report discusses two strategies considered to reduce the use of antibiotic in these conditions: i) No prescription, and ii) Delayed prescription of antibiotics for common upper respiratory tract infections. Moreover, this report calls for a significant modification of the prescribing habits of physicians, and to also extend community awareness on the harms of the misuse and overuse of antibiotics. It is imperative to educate health workers as well as the Community in a coordinated and sustainable manner about the growing public health problem of antibiotic resistance.