Antibiotics: When Do They Help?

Antibiotics are strong medicines that can kill bacteria. They have saved many lives and prevented bad outcomes. These drugs do not kill viruses. They only work on bacteria. Every day, doctors must decide if a child's infection is viral or bacterial. Here's how they do it:

Bacterial Infections. Much less common than viral infections. Antibiotics can help. Bacteria cause:

  • Some ear infections
  • Some sinus infections (not sinus congestion)
  • 20% of sore throats which are Strep throats
  • 10% of pneumonia (a lung infection)

Viral Infections. Most infections in children are caused by a virus. Antibiotics do not help. Viruses cause:

  • 100% of colds. Note: unless they turn into an ear or sinus infection. This happens with 5 to 10% of colds.
  • 95% of new coughs. Note: asthma can also start with a cough.
  • 95% of fevers
  • 80% of sore throats
  • 90% of pneumonia. Note: most cases in children are caused by a virus.
  • 99% of diarrhea and vomiting
  • Note: there are a few anti-viral drugs that can treat viral infections. An example is Tamiflu used for severe influenza.

Cold Symptoms that are Normal

Parents sometimes are worried about common cold symptoms. The symptoms below are not signs of bacterial infections. Nor, are they a reason to start antibiotics.

  • Green or yellow nose discharge. This is a normal part of getting over a cold. It is not a clue to a sinus infection.
  • Green or yellow coughed up phlegm. This is a normal part of getting over viral bronchitis. It is not a sign of pneumonia.
  • High fevers (more than 104° F or 40° C) can be caused by a virus or bacteria.

Side Effects of Antibiotics

All antibiotics have side effects. Some children taking these drugs can get side effects. Examples are diarrhea, nausea, vomiting, or a rash. Loose stools occur because the drug kills off the good bacteria in the gut. If your child gets a rash, it can be from the drug. Your doctor has to decide if the rash is an allergy or not. The biggest side effect of overuse is called antibiotic resistance. This is when the germs are no longer killed by the drug. That's why we only use antibiotics if your child really needs one.

Giving Antibiotics for Viral Infections: What Happens?

If your child has a virus, an antibiotic won't get rid of the fever. It will not help the other symptoms. The drug will not get your child back to school sooner. It will not get you back to work any faster. If your child has side effects from the drug, he will feel worse.

What You Can Do

  • Save antibiotics for bacterial infections when your child really needs them
  • Don't pressure your child's doctor for an antibiotic
  • Treat your child's cold and cough symptoms with home treatment that works
  • Keep in mind that fever is fighting the infection. It also boosts the immune system to prevent future infections.

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC. Date Updated: Mar 31 2025 12:48 Version 0.1

Powered by RemedyConnect. Please read our disclaimer.

< Back to Is Your Child Sick?
Is Your Child Sick?®

latest news

starfish
February 12, 2026
There are cases of measles in NC, and we are aware of exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. 2 doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!
close

Dynamic Is Your Child Sick? v0.3 7/7/2025