Scene 1 (antibiotics are ‘life-saving’) Tong Tong (pseudonym) is two years old, fever for 1 day, coughing for 3 days after the fever subsided, now still coughing and runny, the doctor examined the child and thought the child was just a common cold, prescribed some phlegm medicine. But the parents questioned uneasily: “That’s all you can prescribe, just some anti-inflammatory medicine!” The doctor explained that ‘anti-inflammatory drugs’ could be temporarily dispensed with, but the parents expressed doubt: “Can you do without anti-inflammatory drugs?” Or still insist: “I know my child, I need anti-inflammatory drugs to get better fast!” Scenario 2 (antibiotics are a ‘flooding beast’) Miao Miao (pseudonym) also came to the doctor with a fever and cough, and the doctor examined the child’s lungs for rales, and after taking a blood test, judged that it was “bacterial pneumonia” and wanted to give the child a drip of antibiotics: “Antibiotics? Antibiotics have a lot of side effects, we don’t need them!” There is even distrust in the eyes, as if they “know it well”. This is one of the two common attitudes towards the use of antibiotics, one is to use antibiotics at will, and the other is to refuse to use antibiotics, in fact these two opposite attitudes are wrong. The next step is to get a good idea of what antibiotics are and how they should be applied. 1.What are antibiotics? Antibiotics are a powerful weapon for humans against bacteria! Antibiotics are a class of antibacterial drugs. Strictly speaking, antibacterial drugs are divided into two categories according to the source: antibiotics and chemically synthesized antibacterial drugs. Bacteria are important members of the microbial family, some of which are harmless to humans, while others can cause disease and are called pathogens. Different types of antibiotics and antibacterial drugs have various types of weapons to kill bacteria and other microorganisms, and can deal with different bacteria, some of which are also effective against other disease-causing microorganisms such as mycoplasma, chlamydia, spirochetes and rickettsia. Viruses are a class of non-cellular microorganisms, antibacterial drugs lack the weapons to deal with them and do not have antiviral effects. 2.What drugs are antibiotics? Antibiotics are a big family, divided into many categories, among which those commonly used in pediatrics include: so-and-so cillin (meloxicillin, amoxicillin, piperacillin, ampicillin, etc.), cephalexin so-and-so (cefaclor, cefoxitin, cefixime, etc.), and so-and-so macrolide (erythromycin, azithromycin, etc.), etc. 3.What is the historical importance of antibiotics? Antibiotics are of great merit in the course of human history! In the fourteenth century, the “black demon” plague ravaged Europe and other continents, and prosperous cities became desolate and horrible overnight, and large areas of farmland became desolate. At that time, the epidemic took the lives of about 25 million people in Europe. In addition to plague, cholera, smallpox, typhoid …… and many other infectious diseases have rampantly devoured countless precious lives time and again throughout human history. Who are the black hands that cause and spread these diseases? Scientists and doctors have worked hard generation after generation to discover that these infectious diseases are caused by various pathogenic microorganisms such as bacteria. The history of mankind is in a sense the history of the struggle against bacteria. Before the discovery of antibiotics, bacterial infections accounted for the first cause of human death, and mankind was almost enveloped in a time when bacteria reigned supreme until the invention of antibiotics put an end to this situation. In 1929, Fleming discovered that penicillin produced by Penicillium could inhibit the growth of Staphylococcus aureus, and penicillin was first mass-produced in the United States during World War II, which was also the cruelest era of World War II, when countless wounded were killed not by bullets, but by horrible bacterial infections in various battlefields in Asia and Africa every day. As soon as penicillin was produced, it was immediately put into the field and saved millions of sick and wounded. Penicillin is ranked as one of the three major inventions of World War II, along with the atomic bomb and radar. Since the discovery of penicillin, many other antibacterial drugs such as streptomycin, chrysomycin and erythromycin have emerged one after another, and hundreds of them are currently used in clinical practice. The clinical application of these antibiotics has made it possible to control the infectious diseases that were rampant in the past, which has revolutionized our modern medicine and greatly improved human life expectancy. 4.What is the need for antibiotics? Since antibiotics are a powerful weapon used by humans to “kill bacteria”, it is understandable that antibiotics are mainly needed when bacterial infections are present. In the case of viral infections (common cold, flu, etc.) and immune diseases, the use of antibiotics is not necessary, and is not beneficial or even harmful. So how do you know if your child has a bacterial infection? Not all “infections” and “inflammations” are caused by bacterial infections. Doctors consider whether a child has a bacterial infection or another condition based on the child’s age, symptoms, physical examination and blood test results. But all these (including blood test results) can only be used as a reference for clinicians, after all, “there is no clinical indicator that can distinguish 100% whether it is a bacterial infection or a viral infection”, and many times it is empirical medicine. So it’s not surprising that doctors sometimes have different opinions on the same situation, so don’t push your doctor to ask if your child has a “100%” bacterial infection. Parents who “don’t know much” should be aware that sometimes doctors may give different treatment plans for the same symptoms and the same diagnosis. For example, the same fever for two days, no other symptoms, if the child is 4 years old, all aspects of the situation is good, then the possibility of viral infection is considered to be high, do not need to take any special drugs, high fever can take antipyretic drugs, the focus is on further observation of the condition; if the child is only one or two months old, the situation is completely different, you need to seek medical attention as soon as possible, and most likely the doctor will prescribe antibiotics or even recommend hospitalization This is because newborns and small infants are more susceptible to bacterial infections and their condition changes quickly. For example, if the diagnosis of pneumonia is the same, pneumonia can be caused by streptococcus, staphylococcus, adenovirus, or mycoplasma. The pneumonia caused by bacteria and mycoplasma need to use antibiotics, and the dose should be sufficient, and the course of treatment should not be changed or shortened. 5.What are the dangers of abusing antibiotics? The use of antibiotics without indications, in excessive amounts, for long periods of time or not according to the norms, is antibiotic abuse and may cause toxic side effects. For some allergic people, it may cause allergic reactions, which may be fatal in serious cases. Large amounts of long-term, unregulated use of antibiotics can cause disease-causing bacteria to develop resistance, rendering antibiotics useless. Long-term abuse of antibiotics can also make treatment more difficult due to the proliferation of insensitive bacteria or molds that can cause secondary infections. The following is an explanation of “drug resistance”: “Antibiotic resistance” is a major threat to global health American music diva Kelly Clarkson sang in her hit song “Stronger “What doesn’t kill you makes you stronger…” sings American diva Kelly Clarkson in her hit song “Stronger”. The same is true of bacterial resistance. Antibiotics are a powerful weapon against bacteria, but bacteria are small but powerful opponents, bacteria have been on earth for 3 billion years, they have a strange ability to adapt to the environment, they will not sit still, bacteria are constantly “evolving”, some of them will evolve new types of weapons, in the battle with antibiotics to win and survive. Some of them have evolved new weapons to win and survive the battle against antibiotics. While antibiotics are limited in their variety and mode of fighting, bacteria can evade the blows with a thousand variations. In this way, the fish in the net that cannot be hit by antibiotics can continue to grow by virtue of their tenacity, and they can not only reproduce themselves, but also pass on their “resistance” to other bacteria through their genes, making the bacteria legions more and more powerful, and even the emergence of “superbugs The “superbug” can resist all antibiotics, and doctors have no drugs to use. Unnecessary and unregulated use of antibiotics can accelerate antibiotic resistance, which is one of the biggest threats to global health. According to the World Health Organization, about 700,000 people worldwide die each year from “superbug” infections caused by antibiotic abuse. China is a large producer and user of antibiotics, at the same time, the relevant departments of antibiotics use of supervision is seriously inadequate, the people usually do not need a prescription can easily buy antibiotics in pharmacies, some doctors sometimes prescription is not reasonable, which to a certain extent led to the general public abuse, misuse of antibiotics caused by drug resistance. And in treating patients will have to use new drugs against resistant bacteria, bacteria and come up with a secret weapon against antibiotics, which once again led to stronger resistance to germs, a variety of super germs were born one after another. In the past, a patient with a few dozen units of penicillin can have a good effect, but the same condition now several million units of penicillin also has no effect. 6.How to use antibiotics in a reasonable and standard way? The double-edged sword of rational use of antibiotics! (1) Use antibiotics only under the guidance of your doctor. The actual antibiotics are not only for the purpose of the antibiotics, but also for the purpose of the antibiotics. If you have leftover antibiotics at home, throw them away and don’t share them with others or use them again yourself. The same fever may have a different cause from your child, and the cause of this fever may be different from the last fever. (2) Do not force/ask the doctor to prescribe antibiotics. Make your attitude clear to the doctor: Ask him/her to give me a full diagnosis and prescribe antibiotics if necessary. Understand that medicine is unique and unpredictable, and that doctors can only give the best treatment plan for your child’s condition (there is no guarantee of a 100% cure in any case), and that excessive demands for a “sure cure” or a “quick cure” may lead doctors to choose overmedication. (3) Do not blindly refuse to use antibiotics. Do not blindly refuse to use antibiotics when it is basically clear that the disease is a bacterial infection or is more likely to be a bacterial infection. Nowadays, there is more and more publicity about bacterial resistance and rational use of drugs, and some parents are half-aware of this and go to the extreme of “blind refusal”. (4) Choose the appropriate route of administration. In terms of safety, oral administration is safer, and in terms of onset of action, intravenous injection is faster, but most of the drugs cannot achieve the desired effect when given intravenously once a day in an outpatient clinic. We need to weigh the pros and cons and choose the appropriate route of medication according to the specific circumstances and severity of the disease, rather than the hearsay “I heard that infusion is bad” or “infusion is the only way to get better quickly must be infusion”, so that a child with severe bacterial pneumonia It is also wrong to treat a child with severe bacterial pneumonia with oral antibiotics alone, and to treat him with infusion every time he gets sick. (5) Do not just stop taking medication on your own. Some parents are so anxious when their child has a fever that they even take the initiative to ask for medication, but then stop it on their own once the fever subsides. In accordance with the doctor’s instructions, you should not stop the medication as soon as the condition improves, the course of treatment is not enough when the bacteria resurface easily lead to recurrence of the disease, and incomplete bacterial kill bacteria so that some bacteria fall and “evolve”, resulting in bacterial resistance. In addition, parents should be reminded to follow up in a timely manner, because sometimes doctors only prescribe two or three days of medication because of prescribing authority, but in fact, the course of treatment has not been reached and requires continued use of medication. (6) Actively prevent bacterial infections. Develop good hygiene habits, wash your hands with soap and water frequently (especially after toileting and before eating), avoid contact with patients, and get vaccinations in a timely manner to prevent the occurrence of infectious diseases. (7) Be a propagandist of rational drug use. Bacterial resistance harms not only the one who abuses antibiotics himself, but the powerful spread of bacteria makes it possible for anyone of any age and in any country to be affected. So, do what you can to educate your family and friends about the importance of the scientific and rational use of antibiotics.