Antibiotic Use in Children: How Safe Are They?
Antibiotics should be taken only with a doctor's advice. They are essential for treating bacterial infections, but their use in children must be managed carefully to avoid kidney damage.
Antibiotic Use in Children: How Safe Are They?
Introduction:
Antibiotics should be taken only with a doctor's advice. They are essential for treating bacterial infections, but their use in children must be managed carefully to avoid kidney damage.
Antibiotics are vital for fighting bacterial infections, but using them in children needs careful thought due to the risk of kidney damage. Drug-induced kidney issues are a major concern, causing up to 60% of acute kidney injury (AKI) cases in hospitalized patients, with increased illness and death rates in children. Antibiotics are often the cause.
Dr. Sreenath S. Manikanti, a senior pediatric and neonatology consultant at Kauvery Hospital, Bangalore, points out that most fevers in children are viral and don't often need antibiotics if assessed correctly. "The need for antibiotics in children is much less in outpatient care," he says. For hospitalized children who need antibiotics, the risk of kidney injury can be reduced by choosing the right antibiotics and limiting their use based on blood test results. Some antibiotics, especially aminoglycosides, are known to be harmful to the kidneys and should be used with care.
Dr. Manikanti advises that "if they must be used, monitoring the drug level and kidney function is crucial." He highlights the importance of careful antibiotic use, avoiding combinations, and reducing or stopping antibiotics as the child's condition improves to prevent kidney damage.
Dr. Prashanth Dheerendra, a consultant nephrologist at Apollo Hospitals, Bannerghatta, Bangalore, offers more insights into antibiotic use in children. While antibiotics are often feared for causing kidney disease, Dr. Dheerendra believes this risk is often overestimated.
Dr. Dheerendra shares four key points:
- Most oral antibiotics are generally safe and unlikely to harm the kidneys.
- Injectable antibiotics carry a higher risk of kidney damage and should always be given under a doctor's supervision.
- Some injectable antibiotics can damage the kidneys if used for long periods, so it's important to monitor kidney function during their use.
- Not all patients on antibiotics develop kidney problems. In stable patients, severe kidney damage due to antibiotics is rare.
Dr. Dheerendra lists specific antibiotics known for causing kidney problems, such as amikacin, amphotericin, rifampicin, and colistin. He also notes that in very sick hospitalized patients, many factors besides antibiotics, like infections, low blood pressure, and bleeding, can affect kidney function.
In conclusion, antibiotics are crucial for treating bacterial infections, but their use in children needs careful management to avoid kidney damage. Proper evaluation, careful selection and duration of antibiotic use, and regular kidney function monitoring are essential to ensuring safe and effective treatment for pediatric patients.
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