Monday, October 17, 2011

When does my kid need an antibiotic for her stuffy nose?

I see a lot of kids every day with stuffy noses. It usually goes something like this:

She has had a stuffy nose for 2 days and I don't want her to miss any school so please make her better.

Of course I wish I could make all kids with a stuffy nose better immediately but antibiotics are not always the answer. Most stuffy noses are caused by viruses and antibiotics are not going to help.

So how do I know if your kid needs an antibiotic? There are some clues that make me think more of a sinus infection.

Symptoms have gone on more than 10 days and are getting worse, not better.
Fever (99.9 is not a fever.. Temperature varies throughout the day and no one is exactly 98.6 all the time. Fever is generally 100.5 or higher)
Sinus tenderness (my face hurts!!)
The color of the drainage does not always buy you an antibiotic but thick yellow green drainage in the setting of the other criteria would make me more likely to think of sinusitis. A lot of people have yellow drainage in the morning because they are clearing out pooled secretions from the night then they are clear through the rest of the day. This is not a bacterial infection.

So what do I do if my kid doesn't have these things? They still have a stuffy nose and I don't want it to get worse so can't you just give me the antibiotic??

Well, no. Treating a bacterial infection that doesn't exist isn't going to fix your viral illness or allergy problem. There are things you can do, however.

Saline nasal spray
Over the counter allergy meds like Zyrtec, claritin or allegra.
Nasal steroids like flonase, nasonex, nasalcrom.
Time and patience.

It's not that we don't want to make your child better. We just want to make sure your child has the appropriate treatment.

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