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Do you take a child to the dr the first day they have fever?
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gp2.0




 
 
    
 

Post Thu, Nov 24 2016, 12:15 am
Gold21 you need to update your medical knowledge. You keep talking about how you did your research and you're just giving people advice but the current information disagrees with you.

The CDC and the AAP both want to cut down on antibiotic usage which are often over prescribed. Antibiotics often do more harm than good. Most ear infections are viral. The CDC recommends waiting a few days before giving antibiotics for ear infections.

http://www.cdc.gov/getsmart/co......html

https://www.healthychildren.or......aspx

Overuse of antibiotics results in antibiotic resistance, the destruction of gut bacteria and the creation of superbugs.

Quote:
Overprescribing antibiotics in outpatient settings puts children at risk of serious adverse effects and is the leading source of pediatric Clostridium difficile infections.

By 2020, the U.S. aims to reduce such inappropriate use of antibiotics in outpatient settings by 50%. Reaching this goal requires a significant reduction in unnecessary antibiotic use for acute respiratory conditions, which account for 44% of outpatient prescriptions. Half are unnecessary prescriptions.
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gold21




 
 
    
 

Post Thu, Nov 24 2016, 12:42 am
gp2.0 wrote:
Gold21 you need to update your medical knowledge. You keep talking about how you did your research and you're just giving people advice but the current information disagrees with you.

The CDC and the AAP both want to cut down on antibiotic usage which are often over prescribed. Antibiotics often do more harm than good. Most ear infections are viral. The CDC recommends waiting a few days before giving antibiotics for ear infections.

http://www.cdc.gov/getsmart/co......html

https://www.healthychildren.or......aspx

Overuse of antibiotics results in antibiotic resistance, the destruction of gut bacteria and the creation of superbugs.

Quote:
Overprescribing antibiotics in outpatient settings puts children at risk of serious adverse effects and is the leading source of pediatric Clostridium difficile infections.

By 2020, the U.S. aims to reduce such inappropriate use of antibiotics in outpatient settings by 50%. Reaching this goal requires a significant reduction in unnecessary antibiotic use for acute respiratory conditions, which account for 44% of outpatient prescriptions. Half are unnecessary prescriptions.


Dr Google huh? Lol. You totally misrepresented what the CDC says about ear infections. I'll break it down for you. The CDC does not recommend antibiotics when there is an ear infection present that does not have a bacterial element, aka "fluid in the ears". I have never seen antibiotics prescribed for fluid in the ears with no bacterial element. However, when there is a bacterial element present, it is up to the pediatrician to decide to how to proceed, based on the results of the examination (how bad the infection is, how the child is presenting...)- he may decide to wait a couple of days to prescribe antibiotics or he may decide to prescribe immediately.

As for the quote you listed regarding over-use of antibiotics, you took it from an article which sets out to explain that antibiotics can not cure viral infections. That's pretty basic information... and it concerns me that this article had to be written altogether, that there are adults out there that believe that antibiotics- medication that destroys bacteria- could ever work against a viral infection. If there are doctors out there prescribing antibiotics for viral infections, they should definitely be reprimanded.

Antibiotics does NOT "often do more harm than good". What a misleading statement. Antibiotics save lives. While there do have to be guidelines in place to prevent over-use of antibiotics, the administration of antibiotics when necessary is very important. Antibiotics are amazing and life-saving.

Over-prescribing is not the same as prescribing on an as-needed basis.

My pediatrician does not over-prescribe. He doesn't. I do not take antibiotics, nor give my children antibiotics, when unnecessary. Please stop assuming things about me. I do not need to update my medical knowledge.

Also, I said I'd rather not engage in this conversation with you. I don't feel that our back and forth will go anywhere. I find that when I read the articles you link, I arrive back at my original conclusion. Good night. Hope there's no hard feelings. Just an internet discussion and totally not personal. Tongue Out
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gold21




 
 
    
 

Post Thu, Nov 24 2016, 2:06 am
Raw wrote:
I just have to add to this post. I am an Australian living in NY and my doctor has said the exact same thing about strep in America. It is an alarmist response with a quick antibiotic fix here. Doctors don't even want you to wait to let the body try deal with the strep virus and build immunity. No, they want you on antibiotics RIGHT AWAY.
There is a reason why strep is so common in the US, and practically a non issue in Australia and Britain.


You say "Doctors dont even want you to wait to let the body try to deal with the strep virus and build immunity".... Strep is not a virus. It is a bacteria. We dont build immunity to bacteria the way we build immunity to viruses. That's why vaccines are given for prevention of viruses, not for prevention of bacteria- immunity doesn't work that way for strep.


Last edited by gold21 on Thu, Nov 24 2016, 1:48 pm; edited 1 time in total
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amother
Lime


 

Post Thu, Nov 24 2016, 2:28 am
I didn't read the whole thread,but in answer to the original question - Yes, I generally take my children to the doctor almost right away when they have a fever, but that's mostly because I work. I certainly wouldn't send them to school with a fever, but if they have strep or an ear infection I want them on antibiotics right away instead of spending a few days watching their fever go up and down and not knowing what it is and meanwhile missing work for something that could have been treated right away. When I am off, I generally would wait two days before going to the doctor for a fever unless I really suspected strep or they seemed really sick or had unusual symptoms. I would probably call the doctor after 24 hours of fever and describe the symptoms and ask whether the child should be seen by the doctor.
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amother
Royalblue


 

Post Thu, Nov 24 2016, 3:10 am
I am Australian and agree with what has been said about how different it is there. But there's another big piece of the puzzle which is the serious lack of sick, personal and vacation days in the US, not to mention the pervasive workplace culture that frowns upon taking even those days you do have a right to. Most adults can hardly take off a day when they're sick, let alone for sick kids. So ppl are desperate for the anti biotic that will get them back to work asap.
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gp2.0




 
 
    
 

Post Thu, Nov 24 2016, 8:58 am
gold21 wrote:
Dr Google huh? Lol. You totally misrepresented what the CDC says about ear infections. I'll break it down for you. The CDC does not recommend antibiotics when there is an ear infection present that does not have a bacterial element, aka "fluid in the ears". I have never seen antibiotics prescribed for fluid in the ears with no bacterial element. However, when there is a bacterial element present, it is up to the pediatrician to decide to how to proceed, based on the results of the examination (how bad the infection is, how the child is presenting...)- he may decide to wait a couple of days to prescribe antibiotics or he may decide to prescribe immediately.

As for the quote you listed regarding over-use of antibiotics, you took it from an article which sets out to explain that antibiotics can not cure viral infections. That's pretty basic information... and it concerns me that this article had to be written altogether, that there are adults out there that believe that antibiotics- medication that destroys bacteria- could ever work against a viral infection. If there are doctors out there prescribing antibiotics for viral infections, they should definitely be reprimanded.

Antibiotics does NOT "often do more harm than good". What a misleading statement. Antibiotics save lives. While there do have to be guidelines in place to prevent over-use of antibiotics, the administration of antibiotics when necessary is very important. Antibiotics are amazing and life-saving.

Over-prescribing is not the same as prescribing on an as-needed basis.

My pediatrician does not over-prescribe. He doesn't. I do not take antibiotics, nor give my children antibiotics, when unnecessary. Please stop assuming things about me. I do not need to update my medical knowledge.

Also, I said I'd rather not engage in this conversation with you. I don't feel that our back and forth will go anywhere. I find that when I read the articles you link, I arrive back at my original conclusion. Good night. Hope there's no hard feelings. Just an internet discussion and totally not personal. Tongue Out


Yes I realize you would just like to state your piece with no one arguing with you. But as long as you keep posting alarmist advice without backing it up, I'll keep posting professional sources that reassure mothers that they don't need to overreact like you say they should.
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gold21




 
 
    
 

Post Thu, Nov 24 2016, 9:04 am
gp2.0 wrote:
Yes I realize you would just like to state your piece with no one arguing with you. But as long as you keep posting alarmist advice without backing it up, I'll keep posting professional sources that reassure mothers that they don't need to overreact like you say they should.


Lol....
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mille




 
 
    
 

Post Thu, Nov 24 2016, 9:21 am
Didn't read any other posts really. My gal is still tiny, under a year. She's only had a fever a couple times. Personally I would call if it's 102+ just in case that's not the peak of the fever and it's actually higher. Anything else I wouldn't bother calling and would treat at home. I wouldn't necessarily GO to the doctor - but I'd call and see what they say.
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Maybe




 
 
    
 

Post Thu, Nov 24 2016, 12:30 pm
Strep - It depends which country you live in!

https://www.ncbi.nlm.nih.gov/p.....0301/

DISCUSSION

We have identified fundamental differences in the recommendations for the management of acute sore throat, in particular among guidelines from North America, France, and Finland on the one hand, and from Belgium, The Netherlands, England, and Scotland on the other. Recommendations differ with regard to the use of a rapid antigen test or throat culture and the indication for antibiotics. North American, French, and Finnish guidelines consider diagnosis of GABHS necessary, and prevention of acute rheumatic fever remains an important reason to recommend antibiotics. In 4 of the 6 European guidelines, acute sore throat is considered a self-limiting disease, and antibiotics are not recommended.
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Hashem_Yaazor




 
 
    
 

Post Thu, Nov 24 2016, 1:14 pm
I want to say it IS possible for strep to go away, and if it doesn't, antibiotics can be started in time. This means you can wait out a couple days before seeing a doctor if an illness is not going away and there is no specific symptoms what they may be. I got a home testing kit after always getting negative test at the doctor's and having wasted my time going. Shortly after, all of a sudden, my kids were testing positive -- and out of the 4 that had abx, 2 showed allergic reactions. One of them a few weeks later tested positive late at night, but then felt fine the next day. And I waited a couple of days and the rapid was negative and she was fine. I specifically waited it out with her because of her allergic reaction and I was hesitant to start experimenting with other antibiotics when she really felt fine the next day. So I really suspect all my waiting a couple of days before bringing them in in the past resulted in negative cultures because they did fight it off in the 3 day waiting time or so.

I will bring in quicker if a sickness goes away and then a few days later same child comes down with something -- then I want to rule out a secondary infection vs back to back viruses due to a weakened immune system.
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amother
Natural


 

Post Thu, Nov 24 2016, 6:27 pm
Well, I have 3 things to say. Make that 4.

1. A study was done, and I don't know that I can find it. They compared kids given a rapid culture & immediate antibiotics vs. those who waited for results from overnight culture. In the first group a large number had strep again very soon, and in the 2nd group almost nobody did for several months following the illness, seeming to indicate that allowing the body to develop some resistance to strep would have a positive impact.

2. DH used to say that when you went to Dr. X, you always left with a prescription because if you didn't need one when you arrived, after sitting in the waiting room with all the other kids' germs, you definitely needed one now! (Perhaps he's modified his approach based on CDC or AAP guidelines, I don't know.)

3. Years ago I told my neighbor my approach, based on #1 above, which would be to wait a couple of days. She. a believer in running to the doctor, countered "Don't you want to do the best thing for your child?"

Yes, dear, and my reasoning (see again #1) is that I AM doing the best thing for my child.

4. I recall as I'm writing, a doctor (holistic but he did go to medical school!) once told me that he'll give me a prescription to hold onto. (Evidently it was something difficult to culture. Ears? Bronchi? Don't remember.) If it's a virus, you (or the child) will usually start to feel better by the 3rd day. If not, it's probably bacterial and you can fill the prescription.
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eschaya




 
 
    
 

Post Thu, Nov 24 2016, 10:19 pm
No way. I barely ever take my kids to the doctor (other than well-visits). If the kid feels unwell and/or has fever he gets tylenol, rest and hydration. On the rare occasion when I have actual concern for strep (or other illness that needs abx or other intervention for treatment) of course I will take them in. Exceptions to my laise faire attitude towards fever would be a newborn, an immunocompromised person, or in the case of an unusually high fever. Working in healthcare I guess does give me an advantage in that I can fairly easily rule out serious concerns, but also the fact that I work in an ICU means that I don't take minor illness/injuries too seriously. My kids know that unless you are hemorrhaging, having trouble breathing or otherwise in severe distress... you are fine. (My father is an ER doc and I grew up with the same mentality.)

Rushing to give kids antibiotics when it's not warranted only increasing the likelihood of antibiotic resistance and encourages the development of hardier strains. In the vast majority of cases, ear infections do not need antibiotics. Sore throat does not need antibiotics unless its strep. General febrile illness does not need antibiotics. Viral infections do not need antibiotics.
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amother
Tangerine


 

Post Thu, Nov 24 2016, 10:52 pm
Didn't read the whole thread but I wait a couple days first to see if if goes away on its own.
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amother
Lime


 

Post Thu, Nov 24 2016, 11:09 pm
I am wondering if the mothers who wait out a fever for a few days work. If so, how do you work that out?
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amother
Plum


 

Post Thu, Nov 24 2016, 11:53 pm
I think it really depends on the child.

My oldest child I rarely took to the doctor for sick visits when she was little because she was B"H a pretty healthy baby. Once she was past the danger zone of infancy I would wait a day or so and see how she was doing. If she just had a runny nose but was running around I certainly didn't run to the doctor. If she was lethargic and just not herself then I was more likely to take her. Then she became pre-asthmatic and every cold led to a cough which started her wheezing and she would end up on a nebulizer. Now I'm much more cautious with her and she sees a specialist.

My other kids are B"H usually pretty healthy. I'm a little bit more nervous about coughs because of previous experience. I'm unlikely to take them to the doctor for seemingly viral infections for the first day or so unless I know they've been exposed to something. Over Y"T we were together with family and one of my nieces was sick with what seemed to be a cold. She developed a cough that sounded concerning so my sister took her to the doctor and it turned out to be an ear infection. When my toddler had exactly the same symptoms a week later I took him right to the doctor and sure enough he had a double ear infection. I always let people know when my kids come down with something shortly after interacting with other children so that they know to be on the lookout for whatever symptoms my kid has.

I've been very happy with our pediatric group. They're up to date and cautious about medicating unnecessarily. I can call with questions and they're very responsive. If my kid has nonspecific symptoms and I'm not sure if I should bring him/her in they will tell me that there is a virus going around and it's probably nothing or that there's a strain of strep going around and I should come in for a culture.
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Hashem_Yaazor




 
 
    
 

Post Fri, Nov 25 2016, 10:15 am
amother wrote:
I am wondering if the mothers who wait out a fever for a few days work. If so, how do you work that out?

What is the difference? Most things are viral, and bring the kid to the doctor sooner won't make them better any quicker...

(But that is one of the reasons I got a home strep test kit so that I wouldn't be delaying treatment to get the kid back into school quickly in the case it was strep.)
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amother
Lime


 

Post Fri, Nov 25 2016, 10:46 am
Hashem_Yaazor wrote:
What is the difference? Most things are viral, and bring the kid to the doctor sooner won't make them better any quicker...

(But that is one of the reasons I got a home strep test kit so that I wouldn't be delaying treatment to get the kid back into school quickly in the case it was strep.)


Yes, if it's viral there is nothing to do but wait. But if it is something that's treatable, I want to know that right away rather than have it go on longer than necessary when it's hard enough as it is for me to take off days from work.
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Hashem_Yaazor




 
 
    
 

Post Fri, Nov 25 2016, 12:50 pm
I guess I use my common sense. A cold? Nothing really to do, we don't need a doctor. Fever/lethargy with no specific symptoms, wait it out and see if it is getting worse or not. Difficulty breathing? Usually croup but if it can't be alleviated with ice cold air or hot steamy room, that's different. If pain accompanying breathing, also need to re-evaluate. I've had a baby with pneumonia, and I've dealt with bronchitis as well -- I can usually gauge when it's something out of the ordinary. Something specific pointing to an infection (like my son's MRSA infected toe or a different kid with an abcess) of course warrants dealing with it promptly at the doctor's (though to be fair, those 2 incidences were not a problem of being contagious so much so work didn't really come into play)....Son complaining of pain near his belly button and I supected umbilicial hernia (correctly) of course we brought in (on a Sunday to Urgent Care!) -- again not a contagious problem. Stomach bugs we stay home of course but the doctor can't do anything to make it go away faster. If there was a problem with dehydration or not getting better, doctor can be seen, but that's after a wait.

Basically, I can usually tell if someone needs medical attention sooner rather than later. We've had a couple ER or Urgent Care visits because it really needed to be addressed pronto, and not the next day at the ped. Because my experience is for most everything I think needs to be soon quicker rather than later because it's not viral or is acting different than a typical virus, I don't want to wait overnight either.
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shnitzel




 
 
    
 

Post Sat, Nov 26 2016, 8:27 pm
I take my kids on day 5 of unexplained fever as per the paediatricians guidelines.

I have had a child with cellulitis.

I have worked hard to find doctors I trust with up to date knowledge and we use antibiotics rarely and have never felt my kids were medicated unnecessarily.

My kids get sick often enough after going to the doctor that I will not go just in case. We got (self diagnosed because just a virus and I wasn't exposing other kids either way) hand foot and mouth at our last well visit.
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amother
Coffee


 

Post Sun, Nov 27 2016, 9:57 am
gold21 wrote:
You say "Doctors dont even want you to wait to let the body try to deal with the strep virus and build immunity".... Strep is not a virus. It is a bacteria. We dont build immunity to bacteria the way we build immunity to viruses. That's why vaccines are given for prevention of viruses, not for prevention of bacteria- immunity doesn't work that way for strep.


Actually that's not true. About half of the vaccinations we give are for bacteria. Diphtheria, tetanus, hib and pneumococcus (prevnar) are all bacteria.

As far as ear infections go, AAP guidelines are to treat in children under 2 but to wait and see in older children and use pain relievers and comfort measures. Most doctors (who went to medical school!) do try to adhere to AAP guidelines in their practice.
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