To not give DD these antibiotics?

[HarlettHoHoHoScara]

5 month old DD is poorly. She developed a cough 2 days ago and yesterday her tempertaure shot up and she was sleepy and lethargic.

I took her to the GP yesterday evening who tentatively diagnosed RSV/bronchiolitis. He advised calpol/ibuprofen to keep her temperature down and make sure she was getting enough fluids. He deliberated about prescribing antibiotics and initially said he wasn't going to as they weren't necessarily effective against this type of illness and because she'd had a course of Amoxycillin recently (2 weeks ago for an ear infection). Then he said he'd write me the prescription in case but only to give her the ABs if she really needed them. When I questioned how I would know when she would need them, he wavered again and told me just to give them to her anyway and sent us away with instructions to call OOH if her breathing deteriorated overnight.

I picked up the ABs from the chemist and gave her a dose last night before bed (it's 1 dose a day of Azithromycin) along with calpol and she had a reasonably settled night.

Today she's wheezy (but not struggling for breath). Her temperature is normal, she's much perkier, feeding normally and her colour is better. I'm in 2 minds about whether to continue with the ABs or just wait and see if she continues to improve. If the Dr had been more certain about the need for ABs himself I wouldn't be questioning this at all but he seemed so unsure himself about whether to prescribe them or not.

So, AIBU to skip today's dose and re-evaluate depending on DD's progress over the next few days?

I see your dilemma, however I would err on the side of caution as the doctor has done and give her them, they won't harm her.

I would keep giving them. They are unlikely to harm her, and could well be helping.

I could be wrong, but once you've started a course of antibiotics I thought you had to finish it? Just in case it is a bacterial infection and any lingering bugs develop resistance and thus become harder to kill.

I would also err on the side of caution; give her another dose tonight and see how she is tomorrow before making a decision to stop antibiotic meds.

With ABs once you have started you really should complete.

If you don't there is a chance that any infection she has will become resistant to that family of antibiotics (and yes one dose is enough for that). If that happens then any infection she has will become potentially difficult to treat.

I know its a lot of ifs and buts but with ABs once started you really should complete.

I'd keep giving them to her. We stopped dd's antibios after 1 day of a 5 day course because she reacted badly to them The ooh wouldn't prescribe a different variety. She was looking much better but after 1 day off them she got much worse and we had to start all over again with a new prescription.

I would complete the course now you've started it.

I would agree it's now difficult to know whether your dd would have improved anyway without the antibiotics. If she has RSV this is a virus and antibiotics wouldn't help, just supportive measures (ibuprofen/ calpol) while she fights it off herself. However, if she has improved BECAUSE of the antibiotics, then missing a dose then restarting could lead to the bug becoming resistant and the antibiotic no longer helping.

I would persist with the course if antibiotics now you've started, and am glad little one is feeling better!

Seeing as she has recently suffered with an ear infection I would continue with the course of antibiotics, they must be having some affect if she is feeling a bit better today so I would finish the course.

I would give them.

Babies with rsv are notoriously up and down and it's so hard to get a clear picture of what's going on on their lungs. (I was told my 10 week old's chest was clear, but because of his age and unexplained temp/ loss of voice etc, we had to go to the emergency room. He seemed well enough)

Shockingly, when they x rayed his chest, he had quite serious pneumonia in both lungs - an aspirate test confirmed rsv a few days later, but by then we had already been nebulising him five times a day. The gp would have been quite happy to say 'take him home and watch him' but because of his age and the prevalence of rsv (and the serious ness of the infection in tinies) he had no option but to refer him on.

Rsv is a bitch. If she's still wheezy and has chest crackles, I'd be continuing the course and taking her back in a couple of days if the chest doesn't clear.

If dd has perked up since her first or second dose, I would suggest it is something that is responding to the anti-bs, and continue the course.

Fingers crossed it isn't rsv. The nebulising gave ds1 a phobia about plastic, so made it impossible to bottle feed as he became terrified of plastic near his face.

Hope she continues to recover x

once started antibiotics must be finished unless there is an obvious adverse reaction. Half courses create resistant bacteria and do everyone no favours.

doesn't sound like the GP deals them out like smarties, which is always good.

Never stop once you've started without medical advice. There are two reasons we are going to lose precious, limited antibiotics, which changed the face of medicine. one is people taking them all the time for nothing. the other is people starting courses, teaching the drugs how to fight them, stopping, then the bugs come bat stronger and evolved to deal with those ABs. I work in homelessness and have seen drug-resistant TB. Not pretty.

Although RSV can't be treated with antibiotics they can stop an opportunistic infection though.

As you have started them I would continue

(Should add, we didn't have anti-bs for rsv, but steroids and whatnot delivered via the neb. I'd be continuing the anti-bs as they seem to be working!)

Come back, not bat.

I hate and and would only give them in an absolute emergency so I get your hesitation. However, the others are right. Once you started a course of and you need to finish it or you're doing your daughter more harm than good.

Thanks, folks. Didn't realise that stopping them after one dose could do more harm than good so will continue with them as prescribed.

Definitely carry on giving them, it's only another 2 doses.

Azithromycin works really quickly so her improvement is probably due to that first dose. DS2 frequently has that prescribed and it is brilliant

Fab, we are stopping antibiotic resistance one MNer at a time.

So glad you are continuing with them. It's really important to.

Because of everything MrsTerrys has outlined above I always think that if the Doctor has actually prescribed ABs then it's because a person needs them.

Getting AB's out of Doctors is like getting the proverbial blood out of a stone as it should be so when they do give them they need to be taken, all of them, to the end of the course. At least that's what I think and do.

I would give them.

My eldest DS suffers from bronchitis so has had a fair few courses of Anti Bs in his time but what can you do if they need them?

He was diagnosed the other day with bronchitis and pneumonia so he's on even more meds this time.

Your poor boy, Worra. How miserable for him. Hope he gets better soon.

Neither DP nor I have needed ABs much so I'm afraid we were both unaware of the potential harm in not continuing so I'm glad I posted this thread.

Gave DD her second dose before bed and will be sure to finish the course.