When parents ask for antibiotics to treat viral infections:

• Explain that unnecessary antibiotics can be harmful.
  • Tell parents that based on the latest evidence, unnecessary antibiotics CAN be harmful, by promoting resistant organisms in their child and the community.
• Share the facts.
  • Explain that bacterial infections can be cured by antibiotics, but viral infections never are.
  • Explain that treating viral infections with antibiotics to prevent bacterial infections does not work.
• Build cooperation and trust.
• Convey a sense of partnership and don’t dismiss the illness as “only a viral infection”.
• Encourage active management of the illness.

• Explicitly plan treatment of symptoms with parents. Describe the expected normal time course of the illness and tell parents to come back if the symptoms persist or worsen.
• Be confident with the recommendation to use alternative treatments.
  • Prescribe analgesics and decongestants, if appropriate.
  • Emphasize the importance of adequate nutrition and hydration.
  • Consider providing “care packages” with nonantibiotic therapies.
  • Create an office environment to promote the reduction in antibiotic use.
• Talk about antibiotic use at 4 and 12 month well child visits.

The AAP Guidelines for Health Supervision III
(1997) now include counseling on antibiotic
use as an integral part of well-child care.

• Start the educational process in the waiting room.
  • Videotapes, posters, and other materials are available. (www.cdc.gov/ncidod/dbmd/antibioticresistance)
• Involve office personnel in the educational process.
  • Reenforcement of provider messages by office staff can be a powerful adjunct to change patient attitudes.
• Use the CDC/AAP pamphlets and principles to support your treatment decisions.
  • Provide information to help parents understand when the risks of using antibiotics outweigh the benefits.