The trend represents a welcome reversal of antibiotic prescription practices that medical researchers say have led to the emergence of virulent antibiotic-resistant bacteria. Therapeutic use of antibiotics in hospitals, as a prophylactic (preventative) measure for travelers, and as placebo are some of the other forms of antibiotic misuse that researchers believe nurture the evolution of stronger bacteria types.

A study on respiratory tract infections published in a 2007 volume of the Annals of Emergency Medicine found that “physicians were more likely to prescribe antibiotics to patients who they believed expected them, although they correctly identified only about 1 in 4 of those patients.”

Patients who have no medical training often misunderstand antibiotics and their proper applications. Many parents of young children, for example, view antibiotics as panaceas that can cure a spectrum of ailments; and physicians, wanting to maintain patient satisfaction, often write prescriptions for antibiotics because patients expect them, not because they will work.

A number of government and non-government groups have called for reforming antibiotic prescription practices because misuse and overuse threatens to encourage the development of even more resilient strains of bacteria. The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the American Society for Microbiology (ASM), the American Public Health Association (APHA), the American Medical Association (AMA), and Keep Antibiotics Working are all working to raise awareness of responsible antibiotic use.

According to an article in U.S. News and World Report, the American Academy of Pediatrics and the American Academy of Family Physicians adopted new guidelines in 2004 “for treating ear infections in children, urging doctors to try treating acute ear infections with two to three days of pain relief before prescribing amoxicillin.”

Given that doctors often presume parents want antibiotics for their children, parents with sick children should ask their doctors if any prescribed antibiotics are essential to treatment, especially since antibiotics have been linked to occurences of severe liver damage and even death in young children.

SOURCE: Antibiotic Liver Damage › Studies reveal parents demand antibiotics less often

Acute liver failure

Of all prescription medications, antibiotics are the leading cause of liver failure in children. Drug-induced liver injury, whether caused by antibiotics or other types of prescription medicines and over-the-counter drugs, are more likely to occur in children older than 2 years.

Liver injury and acute liver failure are difficult to diagnose. According to the Cincinnati Children’s Hospital, “most of the time the cause of acute liver failure in children cannot be determined. One study showed that this was the case for about 44 percent of all children who were diagnosed with acute liver failure and about 63 percent for children with acute liver failure under 2 years of age.”

When the cause of liver failure is unknown, a liver transplant is the child’s only option. The greatest challenge posed by the transplant option, however, is that liver damage progresses very quickly while obtaining a donor liver for transplant usually takes a long time. This difficulty in treating ALF in children underscores the need to use certain medications sparingly and cautiously. Too much medicine too fast is one of the leading causes of drug-induced liver injury in children.

The symptoms of liver failure usually resemble a virus at first. The child is typically nauseated or vomiting and constantly fatigued. This condition progresses rapidly to jaundice and encephalopathy, a condition in which the brain fails to work properly and mental confusion sets in. Unfortunately, encephalopathy always occurs when the child experiences sudden and severe liver failure.

Signs of liver failure are less noticeable in infants 28 days old and younger. Babies older than 28 days may behave irritably, have inconsolable crying spells, or sleep more during the day than at night. Older children with liver failure often seem angry, forgetful or confused, have a hard time falling asleep, or feel constantly drowsy.

If a doctor knows with certainty that a child’s liver failure was drug-induced, the condition can sometimes be treated with medicine. If given early enough, medicinal treatments may reverse a drug-induced liver failure altogether.

SOURCE: Antibiotic Liver Damage › The signs and symptoms of liver damage and failure in children

According to a report by the Los Angeles Times, Dr. Frederick W. Fraunfelder and Dr. Frederick T. Fraunfelder of the Casey Eye Care Institute at the Oregon Health and Science University in Portland decided to investigate the possible link between antibiotics and double vision after hearing so many reports of eye problems connected to the drugs. They began collecting all the reports of eye problems associated with the use of antibiotics published since 1986 and found some clear links between double vision (a condition know as diplopia in medicine) and fluoroquinolones.

Of the 171 reports of double vision the doctors found, 76 cases occurred in men, 91 in women, and 4 were unspecified. Although certain types of antibiotics in the fluoroquinolones family were more commonly cited than others in the reports, the doctors found that “the number of cases were roughly proportional to the number of prescriptions written for each drug, suggesting that the problem involves the class of drugs rather than a particular product.”

171 cases in 23 years seems like a very small number, but, as the Los Angeles Times observes, medical researchers and data analysts generally agree that such complications are reported less than 10% of the time.

Although authors of the study, which was published in the September issue of the journal Ophthalmology, do not fully understand the link between the use of antibiotics and the occurrence of double vision, they suspect that it may have to do with the tendons that control the eye.

Antibiotic use is known to cause inflammation of the tendons (known as tendinitis) and tendon rupture, among other problems.

The full Los Angeles Times report can be viewed here.

SOURCE: Antibiotic Liver Damage › Double vision linked to several antibiotics

Before the 1936 discovery sulfanilamide and the 1941 discovery of penicillin, bacterial infections often transmuted into more serious conditions. Ear infections sometimes spread to the brain, causing meningitis. Strep throat sometimes turned into rheumatic fever. And pneumonia, left untreated, sometimes became an infection of the bloodstream, resulting in death.

Today, the U.S. Food and Drug Administration has approved approximately 60 antibiotics for use in children. American doctors dispense an estimated 30 million prescriptions annually for the treatment of pediatric ear infections alone.

Antibiotics have greatly extended our life spans and improved the quality of our lives, but for some patients those same antibiotics can be agents of destruction and death. A number of antibiotics have been weakened or rendered ineffective by inappropriate and excessive use throughout the years, prompting researchers to find new, more potent and effective antibiotics.

The FDA requires drug companies to thoroughly test newly developed antibiotics on adult subjects before it will approve them for use in children and infants. Because children are still developing their organs, they are naturally much more sensitive to antibiotics and other drugs.

However, when the FDA fails to thoroughly examine a drug for safety or “turns a blind eye to serious safety concerns,” as one legislator alleges it did, then the public is put at risk. And of course, the most susceptible patients are the children. Parents who worry about exposing their children to the risk of drug-induced liver injury should talk to their doctor and express their concerns about using certain types of antibiotics.

SOURCE: Antibiotic Liver Damage › Are antibiotics safe for children?