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

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