How to Tell When Antibiotics are Needed for Your Sick Child

Today I want to share with you a guest post by mama Jessica.

Now I’m sure we all have heard about the rampant abuse of antibiotics, but Jessica is a Pediatric Nurse, so she sees how truly life-saving they can be.

It’s in time like these, we can all appreciate the life saving capabilities of antibiotics. Take it away Jessica.

Disclaimer: I (Jessica) am not a physician. Always follow the advice of your doctor and consult him for all medical and health-related questions. If you have any concerns, call your doctor or take your child to the nearest emergency room.

Let’s travel back in time to 1920 or so.

Your son comes down with a fever and a cough, nothing too worrying.

After a few days, he is on the mend, but the next morning he is running a fever again. And everything just starts to fall apart.

He won’t eat or drink. He is delirious with fever.

He struggles to even breathe. The doctor visits and confirms your worst fear, pneumonia.

If he is in the unlucky 40%, he will die.

Your previously healthy little boy who was just running around, playing baseball, and sneaking cookies from the kitchen. And it didn’t matter if you were rich or poor; pneumonia struck all.

When Wait-and-See Isn’t the Best Approach

Antibiotics are completely taken for granted in our culture.

We assume we can get them whenever we need, and many people even scoff at them because they are unnatural.

But did you know that many count antibiotics as one of the greatest inventions of the 20th century?

Yes, that’s right.

Better than the TV, the Internet, and sliced bread. Antibiotics have turned a parents worst nightmare into something manageable, even routine.

They have saved countless lives, and have made this world safer to live in.

Pediatric Nurse That Knows

I have seen firsthand the miracle of antibiotics both in my own children and in children I have cared for in the hospital as a pediatric nurse.

I have cared for children who were admitted in sepsis (a truly life-threatening blood infection) and went home a few days later after antibiotics were given.

I have cared for my 5 year old son who sounded just like that story above, but thankfully the year wasn’t 1920. He was able to get on antibiotics quickly and be back to himself in a week.

I don’t scoff at antibiotics. They are the real deal.

As parents, we are all aware that antibiotics should not be given for everything that causes our little one to get sick, but did you know there are certain symptoms that should raise a red flag?

Maybe it is not always best to just wait and see.

When To Give Antibiotics to Children

1. Pneumonia

It’s still a scary word, even in today’s society.

Around 1.5 million children die worldwide every year from pneumonia.

I have cared for countless children who were diagnosed with pneumonia. They struggle maintaining oxygen levels in their blood. They can’t take a full breath.

It can progress to respiratory failure that requires intubation and a ventilator.

It can occlude so much of the lungs that a chest tube is needed to drain the purulent fluid. Oxygen is also hooked up. IV antibiotics are needed for serious cases.

But more often than not, pneumonia, if caught in time, just requires a dose of amoxicillin and rest at home. That’s it.

Could you believe something so serious could just be cared for by mom at home? That’s how amazing antibiotics are.

What should you be looking for when your child is sick?

2. Prolonged Fever and Wet Coughs

  • A fever that reappears or worsens after 3-4 days of an illness
  • A wet sounding cough
  • General lethargy – Your child doesn’t want to get out of bed or off the couch even after giving Tylenol or Motrin
  • Pale skin

Let’s talk about something a little bit more run of the mill.

3. Ear Infections

They are almost a rite of passage to childhood. What toddler hasn’t had these? (I am sure there are some out there, but I have struggled with these so often, I just can’t believe it!)

My youngest had these all the time.

I could predict the onset of an ear infection without even looking in the ears.

It would start with a sleepless night that turned into a feverish morning. And that’s when I called the doctor. Got antibiotics and better by the next day… Awesome.

So what else should you look for?

  • Tugging at the ears
  • Waking frequently at night or crying a few minutes after he is laid down
  • Fever (sometimes)
  • Drainage from the ears

I do know that most ear infections will just run their course without the need for antibiotics (usually within 2 weeks). So you might naturally question the need for antibiotics.

And I get it, too much of anything is a problem.

But would you refuse all pain medicine after surgery? I doubt it. (I had a pretty routine outpatient surgery, and there was no way I was turning down those pain meds…). So why would we, as parents, subject our kids to weeks of pain if an antibiotic would alleviate it completely in a day or so? Just some food for thought.

Well, if ear infections heal on their own, why are antibiotics even needed? Why are we even talking about them here alongside of pneumonia? Complications, that’s why.

I often see the worst of the worst in my profession which can be pretty scary, especially as a mom.

  • Meningitis
  • Mastoiditis (bone infection)
  • Ruptured Ear Drum
  • Hearing Loss

Pretty scary, right?

Meningitis? From an ear infection?! It happens. And who wants their sweet little baby to have to suffer with hearing loss?


Now for a personal story.

My youngest son started having ear infections twice a month as soon as he turned 6 months old.

Twice a month. That means he barely finished a round of antibiotics before he was started on a new one.

Finally, at 13 months old, he had tubes put in his ears. Within a day, he was laughing more than he ever had before. Within a week, he was walking. Within a month, his speech started to really take off.

It changed my little boy. I couldn’t believe he had been so miserable before. It just was ear infections.

Just imagine, there were children who became deaf 100 years ago all because of a pesky ear infection.

4. Strep Throat

Who has had this one growing up (or even as an adult)?

I have, and it is the worst. I recently had it, and told my husband that my throat hurts so bad that I feel like it is bleeding. Really. It sucked.

A few weeks ago, my little girl was so sick too.

I couldn’t really place my finger on it until I looked in her throat. Her tonsils were huge and there were white patches back there. She needed to be seen ASAP.

But besides the horrible pain, what is so bad about strep throat?

Sore throats aren’t usually that big of a deal. Well, complications

  • Scarlet fever
  • Rheumatic Fever which can lead to life long heart problems
  • Glomerulonephritis: a form of acute renal failure (kidneys)
  • Meningitis: strep spreads from throat to brain and spinal cord
  • Toxic Shock Syndrome (not just with tampon use…)
  • Tonsillar Abscess
  • Closure of the throat from the enlarged tonsils

I have seen emergency surgery take place, immediate fluid resuscitation (to save a life), dialysis, and intubation all from a strep infection. Something that can be treated with a simple at home antibiotic.

As parents, let’s pay attention to these symptoms:

  • Sore throat
  • Refusal to eat or drink
  • Fever (usually high)
  • Swollen, red tonsils sometimes with white patches
  • Drooling or inability to swallow. This is an emergency. Take to the ER ASAP

Strep throat… who knew?

5. Abscesses or Skin Infections

These sometimes occur because of a bug bite, diaper rash, or some other minor scratch that didn’t heal properly.

A majority of the time it is due to a staph infection.

We all have had and have seen some skin irritation on ourselves and our children, but when do we start looking for an infection?

  • The spot is getting bigger. Once you notice it, feel free to mark the borders with a pen or marker. Keep an eye on it and see if it goes past those marks
  • The area looks “angry.” This is the totally legit term we use in healthcare all the time, but seriously though. What is meant by “angry” is it is red and swollen and looks painful. Red, not really pink
  • A fever develops out of the blue
  • A streak has developed from the original irritation, usually towards the heart
  • Painful, always painful. Never itchy

If it is caught early enough, the doctor can sometimes just prescribe an antibiotic ointment.

If it progresses, oral antibiotics will be given. If it is pretty serious or doesn’t respond quick enough, IV antibiotics will be given. Surgery is also an option, to drain the infection out.

If you just wait and see for too long, complications can develop.

Basically, the big concern is sepsis (the infection enters the bloodstream) and the destruction of nearby tissues (muscles, tendons, bones, brain, etc.). If it is on the face, especially near the eyes, it is almost always treated ASAP.

Blindness can occur.

  • Sepsis
  • Destruction of nearby tissues and structures (muscles, bones, organs, etc.)
  • Meningitis
  • Blindness

Pretty Unexpected, Right?

All these common illnesses can have horrible consequences.

And they did, not that long ago. So let’s make sure we act when we need to act, and always follow your own intuition about your child. I cannot tell you the number times something serious was caught at an early stage because Mom said, “Something just isn’t right.”

Oh, and a quick shout out to antibiotics. We might not be alive today without them.

Leave a Reply


Jessica, Thanks so much for this information. Even though I’ve had negative experiences with using antibiotics (my son developed serum sickness-like reaction and my husbands’ gut is ruined) I know the life-saving quality antibiotics have. It makes it much harder when my son is allergic to Penicillin (as I am too) and is only 5 years old. With strep and ear infections rampant now that school has started, I’m forever worried for him since the next level of antibiotics don’t work as well as Penicillin does.Reply to Elna
Jessica Crockett Thank you for your comment! Antibiotics are awesome and scary at the same time, and I am so sorry that you have to deal with a lot of the negatives.Reply to Jessica