Repeated antibiotics

[Ourbabyava]

Hi so some background on our daughter, she is 3 in January, about a year ago her breathing started to be very noisy and sounded like it was obstructed, she got diagnosed with very enlarged tonsils and over the first half of this year has been on antibiotics probably around 10 times for tonsillitis. It was so horrible hearing her breathing like it and everytime it got really bad we took her to GP and they put her on them and they seemed to help. In the summer she had a few weeks where it actually improved and we started to think maybe they were giving antibiotics to her too easy, and since then the bad breathing has come in waves without having any antibiotics, she is due to have her tonsils out soon. Just recently she has had antibiotics again for 2 chest infections and now just been prescribed again for an ear infection, we are so worried about how many she has had and read not only about antibiotic immunity but also the negative impact they can have on gut bacteria and even increasing risk of illness. GP just shrugs any questions off but could her health be permanently affected by having so many?

Thanks for any thoughts

She should be having her tonsils removed. Speak to a different doctor. That one sounds useless

She is having them removed, it took a while to get it going but we are concerned about how many antibiotics she has had while we have been waiting for it to get the go ahead

Someone I knew had this with her little boy. NHS refused to take his tonsils out. She ended up going private for a consultation and was prepared to get into debt to pay for the operation privately. The consultant agreed it needed doing, he also worked under the NHS so offered to move him to his NHS list so the only thing she ended up paying out for was the consultation.
Her little boy was 4 though so a little bit older.

Sorry crosspost. If they're getting removed I don't think you have a lot of choice other than put up with the antibiotics - doctor is probably shrugging you off as what else can he/she do.

We have held off going gp with the breathing since July and realised it comes and goes even if she doesn't have antibiotics, decided we would only take her if she seemed ill and one doc said look for white spots on tonsils. Thing is we were encouraged to take her everytime she seemed to have tonsillitis as it then built a case up to have them out, but it also resulted in another course of antibiotics

If you don't think the antibiotics are doing much then don't give them and see how you get on? Unless it's bacterial tonsillitis antibiotics won't be doing anything anyway.

She has them now for a ear infection which I think is probably warranted, it more a concern of how many she has had in the past and what issues that could cause we are bothered about

Is she having 5 day courses - the standard for tonsillitis? Does she have white tonsil spots?

Ds was fine until he first caught strep A, had 5 bouts of tonsillitis the months after (5 day course of antibiotics which never fully cleared it) - 5 days of antibiotics, a few days passable, then back to strawberry tongue and white patches on tonsils again. He's had strep a twice more since then, both 10 day courses, cleared completely.

I've asked gp and a&e (he's been kept in a few days a couple of times for iv fluids) and they say tonsil removal won't help as it's strep. But he just keeps getting it. And his little sister isn't catching it at all, which is weird.

OP how long is the wait for tonsils out? My DS had glue ear and needed grommets put in and adenoids out. He had 12 lots of antibiotics in under 9 months and was unwell every other week with repeat infections as antibiotics stopped working.
On one trip to a and e 10th infection due to very high fever the Dr was gobsmacked at how many lots of antibiotics he'd had. His words were it's malpractice to give a child more than 3 lots of antibiotics for the same issue without a paediatrician reviewing it as it can permanently wreck them being able to fight infection and be immunocompromised. I was horrified by this but even complaints to PALS didn't work and ENT deemed my son not urgent and constantly got fobbed off basically saying my DS issues were all my fault and parenting issues not a health issue. We raised funds and went private as he couldnt wait another year. My DS is now infection free, no sleep or breathing problems and happy and can hear properly. The private consultant said had it not been done it could cause permanent hearing loss from repeat infections damaging his ear canal.

I would push for 2nd/3rd opinions and put in some complaints. Your poor child.

Length of course has depended on which antibiotic was used as there has been times when certain ones were out of stock. It's taken about a year from first issues to operation, around 6 months to get approval and 6 months from then to op date.

That's very worrying about the possibility of immunocompromised 🥺 how is your little one now, any sign of issues from all the antibiotics?

@Blessedbethefruitz I'm in a similar situation with my daughter. Scarlet fever in April and Strep A twice since. What is going on?! Does it lie dormant in the body or something?!

The trouble is the NHS only give them for a week or so, not enough time to clear the infection and so it comes back, so you get another weeks worth.

A colleague has a DC with broncholitis (I think that’s the right word) and they took him to a private GP who prescribed 3 months worth to really clear the infection. They were to take him back straight away if the cough started again.

Oh bless you that's a long time.

Thankfully nothing too serious yet. He had covid in October and was OK. He had a bad cough for over 6 weeks so took him to the Dr who gave him some chewable tablets (not antibiotics) and it helped to clear his cough within a week. He's happy healthy no infections since his op over 3 months ago. Eating well and gaining weight finally. It's such a relief. It had been an 18 month battle from knowing something was wrong with his hearing and sleep apnea/snoring etc tonsillitis to then all the double ear infections starting and him literally being unwell every other week. Literally was either at the GP or a&e on weekends with him as his temp would spike to over 40C which was scary. The final straw was when NHS ENT saw him did the hearing test and said yes he's urgent surgery within 8 weeks to then saying no he's not you'll be waiting a minimum of another year I just said enough is enough and fundraised to go private.

I really hope your little one is OK and all goes with with the surgery and they're pain and infection free. Can you ask them to check for glue ear while they're doing the surgery and enlarged adenoids for the breathing as normally they do all 3 in one surgery if needed. My little boys tonsils are small and fine so they didn't take his out but I know a lot of kids on the NHS and private have it all done at the same time.

Our gp said some kids get it a few times each winter - wtf?! We're lucky if it kicks in during the weekday, or otherwise it's 111 or a&e depending on how fast he's gone downhill.

He's on day 5 of antibiotics this time and we've started sterilising his toothbrush daily - it's a considerable potential cause of bacteria build up/infection apparently.

It's bizarre, and unhelpful now he's in reception. He recovers enough usually to return to school on day 2/3 after antibiotics, but it takes it out of him for much longer - and they give so much more homework than any other local schools, he's not managing it all.

They are doing adenoids at the same time, but never had issues with ears or hearing until today when been diagnosed with ear infection. Her tonsils are permanently very swollen and almost touching, still can't work out why she can have a week or 2 of sounding awful at night to being almost normal for the next couple of weeks, even though there's no change in size of tonsils.

Have you asked if there is a way of knowing if the antibiotics have compromised her immune system?

I can't even count how many antibiotics I've had, maybe 70 courses in my lifetime
No issues except for the ones I already bad

I’ve never given either of my DC antibiotics for anything - ear infections or chest infections. They’re self limiting conditions. They are both in their late teens now and never had antibiotics and are incredibly fit kids.

i did check in with the GP initially (and in your situation I would) and ask them if they’re happy for you to just manage with fluids and pain relief 😊

Sometimes they don't clear up without them

She gets colds and runny nose often but she does go to nursery, it's not very common that she seems ill even when she had tonsillitis only a couple of time she had a temperature and wasn't herself so I guess that's a good sign. We did ask yesterday if she really needed the antibiotics this time and they said yes as one of her ears is quite inflamed

Make sure you give all antibiotics exactly as prescribed. Antibiotics resistance is a bigger problem when you don't follow the instructions or when you have prophylaxis prescription. My gran had repeated urine infection and was on preventive (prophylaxis) antibiotics for something like 10 years at a low dose. She ended up doubly incontinent and for the last 3 years of her life she was probably on full dose antibiotics 2 weeks a month. She did develop some degree of antibiotics resistance but considering the length of continuous antibiotic use with the high infection risk she didn't do too bad.

I had frequent bouts of tonsillitis 9+ times a year and I was 13 before they agreed to take them out. I had similar frequency of antibiotics as your daughter between the ages of 2 and 13/14 when the removed them. During the last year I sometimes needed 2 courses of antibiotics. I have had no long term consequences of antibiotics use and in the 20 years since having them removed I have had tonsillitis twice and have had antibiotics maybe 5-10 times tops.

The biggest issue with antibiotics use is gut flora. I would recommend looking into pre and probiotics foods and include them in their diet as much as possible. Whenever we had antibiotics my mum used to make sure we have some yoghurts at the same time to help reduce the impact on our microbiome (she didn't use the word through!) and reduce the risk of thrush or similar

Oh that's good they're doing adenoids to help her breathing.
Goodness that's scary. I hope your not waiting much longer. Sounds very stressful.

I haven't asked if there is a test to know if he's now going to have issues going forward. He's got probiotics to help build his immunity back up but I guess time will tell. At nursery over half the class went down with v+d bug but he's not caught it all so that's a good sign. Hopefully he doesn't still get it. 🤞🤞

Thank you that's some really good information and gives us hope

@Superscientist this is really reassuring, thank you!

Some antibiotics do a real number on the microbiome and others the microbiome can recover pretty quickly.
Broadspectrum are usually worse.

You can improve the gut microbiome with probiotics and prebiotics and just generally making sure of a healthy plant heavy diet (as in a variety of plants) and limited sugar.

Do not buy yakult or something like that because they’re so loaded with sugar it’s silly.
You want a good multistrain probiotic from a health shop or pharmacy (like optibac/udos/biokult) and things like garlic/natural yogurt are also good.

The problem with antibiotic resistance is generally more of an issue at the population level. As in the bacteria strains become more resistant across the population. When it happens in an individual it’s usually either that they are being treated with the wrong one/don’t have a long enough course/don’t complete the course etc or it can be that the individual is immunocompromised.
(For example with a virus infection in an immunocompromised patient- if they can’t clear the infection- E.g. covid - they can be covid positive for months and the virus mutates within them and then can potentially cause a new strain.) sorry - I’ve fallen off on a tangent somewhere 😂

The absolute best way to build an immune system is good food, sleep and exposure to ancient microbes to build a microbiome (and that means the bacteria we evolved with and that exists in lightly rotting plant matter, water and soil - not by catching an infectious disease.)

So although the antibiotics may have hindered the growth of a healthy microbiome- it may not be as bad as you think and it can be recovered quite quickly with care.
And it’s good the root cause is being dealt with.

She has now been sick 3 times over the last 24 hours, but still seems ok. Could this be down to the antibiotics? She has also struggled to put weight on over the last few months and just weighed her tonight and has lost .3 of a kilo since this time last month. Could all the antibiotics have messed with her gut health so much it's now affecting this?