Antibiotics and Immunity in Children

Antibiotics that should not be given to children result in various organ disorders. Be careful.

Editor's note: this article was published in the daily Kompas on Sunday, April 10 2005. The article was republished to accompany a series of reports investigative Kompas regarding prescribing antibiotics haphazard and the bacteria-resistant impact they cause.

KOMPAS/LASTI KURNIA

Children, including infants, do not need to consume antibiotics for the flu. Giving inappropriate antibiotics will only result in a decrease in their immune system that is currently awakening.

Discussions about the need to be cautious about the irrational use of antibiotics have been frequently brought up. However, the "campaign" to combat irrational use of antibiotics is still less prevalent compared to the reality that is happening on the ground. Children, including infants, are indirectly often targeted as the "niche market" for various antibiotic products prescribed by doctors.

Until today, some doctors still tend to show their dislike when faced with critical patients. There are still many patients - who are essentially medical consumers - who are hesitant to ask many questions to their doctors and choose to simply nod their heads when given any medication by the doctor.

“Actually, it's funny if we don't know what we're actually paying for. Moreover, what we pay is for consumption by our children, which is God's mandate. "This ignorance is often ignored by the medical community, in fact it is often exploited," said Dr Purnamawati S Pujiarto, SpAK, MMPed, who actively educates parents in consuming medical products and services, including through mailing lists (mailing list). .

Also read: Many Doctors Still Carelessly Prescribe Antibiotics

As explained by Purnamawati, the word antibiotic comes from the words anti and bios (life, living). Thus, antibiotics are substances that can kill or weaken living organisms, namely micro-organisms (microbes), such as bacteria, parasites, or fungi. Antibiotics cannot kill viruses because viruses are not living "entities." They cannot reproduce independently and require genetic material from a host cell, such as a human body cell, to reproduce.

SATGAS HUMAS DAMAI CARTENZ POLRI

The medical team from Binmas Noken Damai Operation Cartenz checked the health condition of children in Dogiyai Regency, Papua, Sunday (16/10/2022).

Not for the flu

Meanwhile, it is still common for doctors to easily prescribe antibiotics to infants and toddlers who only have the flu caused by viruses. Indeed, flu symptoms that accompany it sometimes make parents panic, such as fever, cough, and runny nose. Therefore, many parents actually urge doctors to provide antibiotics that are considered as "miracle drugs." Irrational patients like this seem to demand that doctors become magicians. However, antibiotics do not speed up, let alone cripple, the flu virus.

"Parents, who are entrusted by God to take care of their children, should not hesitate to ask the doctor whether antibiotics are really necessary for their child. Isn't it caused by a virus? Ask the doctor about it," said Purnamawati.

However, sometimes facing critical parents, some doctors argue that antibiotics should be given considering the child's weakened immune system due to the flu. If not given antibiotics, it will provide an opportunity for viruses and other germs to attack.

Also read: Invulnerable Bacteria Take Our Lives

Regarding this matter, Purnamawati responded, "Since birth, we have been equipped with a sophisticated immune system. When attacked by infectious diseases, the body's immune system is triggered to work harder. Infections caused by viruses can only be overcome by boosting the immune system through good nutrition and adequate rest, as well as given fever-reducing medication if the temperature is above 38.5 degrees Celsius. So, antibiotics are not necessary, unless we have an immune system disorder such as HIV. Flu will heal on its own, antibiotics only give a placebo effect."

A similar sentiment was also expressed firmly by pharmacologist Prof. Dr. Iwan Darmansjah, SpFk. "The antibiotics given should not be given to children as they will damage their immune system. The result is that the child's immunity actually decreases, and they get sick again. Then, if given antibiotics again, their immunity decreases again, and they get sick again. It continues like that, and visits to the doctor become more frequent because the child becomes more prone to getting sick," said Iwan.

KOMPAS/RIZA FATHONI

A doctor from the Kramatjati Sub-district Health Center accompanied by local posyandu cadres, dasawisma officers, and Kramatjati RT officials in East Jakarta, checked the body temperature of toddler children before administering immunizations by visiting homes, on Tuesday (22/11/2022).

Purnamawati emphasized that children need new antibiotics when they have an infection caused by bacteria. Examples of diseases caused by bacterial infections are some ear infections, severe sinus infections, sore throat due to infection with streptococcus bacteria, urinary tract infections, typhus, tuberculosis, and diarrhea due to Amoeba histolytica. However, if antibiotics are used for nonbacterial infections, it can actually cause the growth of resistant bacteria.

"It should also be noted that for throat inflammation in babies, research has proven that 80-90% of cases are not caused by streptococcus bacterial infections, so antibiotics are not necessary. Inflammation due to streptococcal infections almost never occurs in children under the age of two, and is even rare under the age of four," said Purnamawati.

Child organ disorders

Several conditions that need to be observed when children consume antibiotics are digestive system disorders such as diarrhea, nausea, vomiting, colic, skin rashes, and swelling of the lips, eyelids, and respiratory problems.

Various studies also show that giving antibiotics at an early age will trigger allergies in the future. (Ret.)

Another possibility is the disruption due to the side effects of some types of antibiotics, such as fever and blood disorders where one antibiotic like chloramphenicol can suppress bone marrow, causing a decrease in the production of blood cells. Then, there is also a possibility of liver disorders, for example with antibiotics like erythromycin, flucloxacillin, nitrofurantoin, trimethoprim, sulfonamides. The group of amoxicillin clavulanate acid and macrolides can cause allergic hepatitis. Meanwhile, the aminoglycoside group, imipenem/meropenem, ciprofloxacin antibiotic can also cause kidney disorders.

Also read: A little sick, don't run to antibiotics

If your child really needs antibiotics because he has a bacterial infection, make sure the doctor prescribes antibiotics that only work on the target bacteria, namely narrow spectrum antibiotics. For mild bacterial infections, choose those that work against gram-positive bacteria, while for more severe bacterial infections (typhus, pneumonia, appendicitis) choose antibiotics that also kill gram-negative bacteria. Avoid using antibiotic ointment (except eye infections), as well as using more than one antibiotic unless TB or serious infections in hospital.

KOMPAS/ADRYAN YOGA PARAMADWYA

Students are trying to cough up phlegm for TB or tuberculosis screening at the Daarul Rahman Islamic boarding school in Jakarta on Tuesday (14/11/2023). The Lentera Anak Foundation, in collaboration with the Jagakarsa Community Health Center, held education and screening for TB and non-communicable diseases (NCDs) for the students. This activity aims to support efforts to tackle TB in Indonesia.

If a child is forced to undergo surgery, to prevent infection, antibiotics do not actually need to be given for a long period of time. "Even in major surgeries like heart surgery, antibiotics are only given for two days," said Iwan.

Purnamawati advises parents to always make photocopies and archive all drug prescriptions from the doctor, and it wouldn't hurt to consult with a pharmacist before redeeming them.

Also read: Who is the doctor, me or you?

Since the last few years, new and stronger antibiotics have not been discovered, while germs continue to become more sophisticated and resistant due to irrational use of antibiotics. This is what will become a big problem public health. Antibiotics in proper use are a lifesaver, but if used inappropriately and brutally, they will backfire.

“Antibiotics are like a double-edged sword. "For this reason, the mass media plays a big role in informing about this and there is no need to worry if the pharmaceutical industry doesn't want to advertise," said Iwan.

Also read: Antibiotic sales in Indonesia reach IDR 10 trillion