Are We Overusing Antibiotics? The Dangerous Habit Parents Need to Know About

Antibiotics save lives—but are we using them too much?

In many homes, antibiotics have become the go-to treatment for almost everything: coughs, colds, fever, sore throats, and stomach illnesses. But antibiotics do not cure every infection—and overusing them can create serious long-term problems.

In this episode of Healthy Beginnings, Dr. Edgar Kalimba explores the growing culture of antibiotic misuse, especially in African communities, and explains why antimicrobial resistance is becoming one of the biggest threats to child health worldwide.

In this episode we discuss:

•  Why antibiotics do not work for most viral illnesses 
•  The dangers of overusing antibiotics in children 
•  What antimicrobial resistance actually means 
•  Why some infections are becoming harder to treat 
•  Common misconceptions about antibiotics in everyday parenting 
•  How to know when antibiotics are truly needed 

This episode is designed to help parents make safer, smarter decisions about antibiotics—and understand why “more medicine” is not always better medicine.

Healthy Beginnings offers clear and evidence-based conversations about children’s health, family wellbeing, and the systems that shape our lives. 

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Have a question? Email: healthybeginningspodcast@gmail.com

Produced by LF Media

Transcript

SPEAKER_01 0:00

Across many parts of Africa, including here in Rwanda, antibiotics are often used without prescription. You know, people walk in into pharmacies and pick up antibiotics or request or ask for antibiotics. Thankfully, these have started to reduce with some restrictions on pharmacies, and with good reason, because as you will see in our conversation today, antibiotics are a specific tool, a powerful tool that should be treated appropriately. I've also seen and heard that you know people share antibiotics within the family. One family member gets a prescription of an antibiotic and they end up sharing it. You know, if one child has been given antibiotics, you end up giving the other child because you presume that they would also benefit. Or really taken when they are not actually needed. So this is going to be our discussion today. And so the fact that antibiotics are a powerful tool, using them incorrectly can have serious consequences. And I would like to really start from the beginning today and go a little bit back and speak about infections in general. When we talk about infections, what do we mean? What are the different types of germs and when antibiotics are useful and when they are not, and why we must be careful and use them judicially and appropriately. So starting from really what causes infections, the word infection is very broad. So when your child gets sick with a fever, with a cough, with diarrhoea, it's usually caused by something we call a germ or a microbe or a pathogen. And I would say broadly there are four main types of germs or main groups of germs. The first one is bacteria, understandably, and bacteria cause bacterial infections. And I'll give examples. But bacteria can also cause urinary tract infections, they can cause some skin infections, they can cause throat infections. Many different types and scenarios caused by bacterial infections. So sometimes people say, um, I went to see a doctor, I took my child to see a doctor, and my child has a blood infection. And I'll come back to that because sometimes it's what I would call a misnomer, uh, the way it's communicated and the way it's interpreted. So bacteria is one group. The other group is viruses. Now, viruses are actually much more common in children compared to bacteria. So all your colds and flus and most of the acute coughs in children, especially in preschool and younger and in babies, most of the time, I would say probably around 80% is actually viruses. Now, this is important because antibiotics only and strictly kill bacteria. They do not kill viruses. So if you your baby or your child has a cold or a flu or a cough that is not a pneumonia or it's not a protracted bacterial bronchitis or something bacterial, obviously the doctor needs to really check. You do not need to give your child antibiotics. This also applies to most sore throats. You know, when you have a sore throat, uh, when your child is suffering from a sore throat, again, most of the time these are viral. Yes, you can have uh a bacterial tonsillitis or what we call a pharyngitis, a bacterial throat infection, but this is the minority, the majority are really viral. The other commonly viral illness is actually diarrhoea diseases or diarrhoea and um uh tummy absets in general. Again, in children, these are typically viral. Now, the third group after bacterias, after bacteria and viruses is actually parasites. So parasites is another group of organisms or microbes. The common one obviously is malaria. We all know that we don't treat malaria with antibiotics, we treat malaria with antiparasitic or anti-malarial treatment. Completely different type of drug. Same with things like worms and other parasitic infections. And then you can also speak about a fourth group which we call uh fungal infections or fungi. So, fungal infections, the common ones are skin infections like ringworms, but there's also like uh uh genitalia used infections like valvovaginitis and so on and so forth. So, again, these are fungal infections, and they are treated with antifungal treatment, not antibiotic. So you can see that if you look at the broader uh causes of infections in general, it's only a portion of these infections that need antibiotics, the ones that fall in the category of bacteria. I think this is important to understand because sometimes as healthcare providers, we take it for granted and we don't explain these things. And I've had frequently, all the time, parents asking me, my child has fever, they have a bad flu. Can I please get an antibiotic for them? And I have to explain that no, no, this is I've examined your child, they don't have an ear infection, they don't have a bacterial throat infection, there's no bacterial pneumonia, this is a flu, cold and cough, you do not need antibiotics. So um when you use antibiotics inappropriately and you use them, for example, for an illness that is clearly viral or parasitic or fungal, obviously you're causing more harm than good. Uh antibiotics will only strictly help for bacterial pneumonia or for a bacterial infection, but not for uh a common cold. So if I just briefly speak about um what children present with frequently, you know, especially in in the first years of life, the most frequent symptoms that children present with a fever, a runny nose, a cough. Um when you use antibiotics for these symptoms which are actually viral, um you cause some problems, which I would like to briefly uh speak about now. Within the scope of uh antibiotic misuse, there's one very common and important scenario that happens. You probably have heard of what we call antibiotic resistance. And antibiotic resistance really what it means is that when you use antibiotics too often and incorrectly, bacteria can change and become stronger or become resistant. And this is what we refer to as antibiotic resistance. And what it really means is that an antibiotic that used to treat that specific bacteria simply stops working. It's no longer effective because this antibiotic has been abused or used inappropriately and hence has driven the development of resistance by the same bacteria that used to respond effectively before. So infections, in essence, become harder to treat, and even what you would call common infections become dangerous because they are not responding to antibiotic. And in fact, this is not a future problem, it's already happening for the last many years. And depending where you read, globally, we estimate that probably about five million deaths annually are associated with antibiotic resistance. Whereas somebody is treated and they simply don't respond, and it ends up being fatal. And many people say that by 2050 this number will probably have doubled. So it's really a big, big, big problem. And when you think about the journey and the process of developing a new antibiotic, it takes about 10 to 15 years from the time a new molecule is tested through clinical trials and through research. Um, phase one, phase two, phase three, the entire clinical trial phases to the point where they are safe and effective, and it has been scientifically proven, and the regulators have authorized that it can be given safely to patients. It takes a long time. And in fact, we do not have many. Um, if you look at the groups of antibiotics that we use, there's different groups of antibiotics. Looking at groups in their entirety, it's been decades since we had like a new group of antibiotics um discovered. So we really have to take care of these precious tools, uh, the antibiotics, because there's a lot at stake. Apart from antibiotic resistance, there's something that probably a lot of people don't realize and don't think about. And this is something related to the good bacteria that we have in our bodies. So we all have good bacteria, especially in our intestines, in our gastrointestinal system. The technical term for that is microbiome, that's what we call it. These bacteria are extremely important. They bring about balance and they play a role in immunity. So when you take an antibiotic, yes, it kills the bad bacteria, but it also has an impact on the good bacteria. So, in essence, you lose part of the good bacteria, and with that, you also lose the the benefit of having them in your body. And that's why, you know, sometimes people take antibiotics and they they get symptoms like diarrhea, they get, you know, their tummy gets upset. Uh, it's partly related to that. And often, depending on the class of antibiotic, your digestion might be disrupted, your immunity is affected, and that's because of the influence on the inflammatory pathway, or what we call the it's really related to the immune system. So with the years going by, we there's a growing understanding of uh this element, this microbiome, and its importance for long-term health. So antibiotics are not benign, something to just take anyhow. There's really a price uh to that that could be medium to long term. And again, of course, um you can get side effects. Side effects from antibiotics are relatively common. Thankfully, most of them are mild, maybe a mild skin rash. You might have a mild diarrhea that stops when you finish your course of antibiotics. But I have also seen, I've witnessed myself, very severe allergic reactions from antibiotics that can range from uh very severe skin manifestations, but also what we call an aphylactic shock or reaction. So you can actually get a fatal allergic reaction from an antibiotic, especially if it's the first time, uh, depending on the class, depending on your genetic history, this does happen. So, all of this to say that antibiotics are not benign, something to just walk into the pharmacy and ask, can I get an antibiotic? Um, this is something that should be very clear. Uh, do not expose your child to an antibiotic unnecessarily. Let a healthcare provider appropriately prescribe it and use it as prescribed. The simple rules really for your family and for your baby and for your children is that use antibiotics strictly when they are prescribed by a qualified healthcare provider and always complete the full course. Even if the child improves after one or two days, and maybe it was prescribed for five days or seven days, it's important that you complete the course. And again, like I said at the beginning, never share antibiotics between people and never keep leftover antibiotics for future use. This is also a big no. Because antibiotics are a precise tool and not a general cure. So, why does this matter for your child? Um, every time an antibiotic is used correctly, it saves lives, obviously prevents complications, but every time they're misused, we increase the risk that they may not work when we truly need them. So this is really not just about one illness, it's about protecting your child's future health. So, again, um as I wrap up and attend to some of your questions today, I think the key takeaways are that not all infections are the same. I hope this was clear from our conversation today. And to keep in mind that antibiotics only strictly treat bacterial infections and not the other types of infections. And as I mentioned, most childhood illnesses are viral and do not need antibiotics. So misusing antibiotics can harm both your child and the wider community. So the one element that I would like to mention before I wrap up is the common discussion around blood infection, blood infection, my child has a blood infection, I have a blood infection. So a blood infection, which actually in the medical terms we call it um septicemia or sepsis, it has a strict meaning. It means that you have a bacterial infection, and there's bacteria that is actually circulating in your bloodstream, and we've tested for it, and we've cultured it and we've confirmed it. So most of the time, a blood infection is actually a misnomer. What it really means is that your child has a fever, they did a blood test, and what we call uh inflammatory markers or infectious markers were picked up on the blood test. They were high. So often this is very nonspecific. Um, you might have, let's say, a throat infection, and when you take a blood test, your serioactive protein or your procalcitonine or other inflammatory markers or nonspecific infectious markers are high in the blood. So, strictly speaking, this is not uh a blood infection, and I think it would be appropriate for me to delve deeper into this and shed more light. But for today, I hope the message is clear what antibiotics are, when they should be used, how they should be handled, and the cautions around them. Before we leave, I would like to answer some of the questions that were sent to us by the listeners.

SPEAKER_00 18:55

First question from Betty from Uganda. I grew up using traditional remedies for most illnesses, and they've worked for me. But now my children prefer going straight to the hospital. How do we balance between traditional knowledge and modern medicine safely?

SPEAKER_01 19:09

So thank you for the question. Many patients often ask me about natural remedies. Um, you know, the home-prepared natural organic remedies. And my immediate response is always, I didn't study that in medical school, so I can barely comment on it. However, I will share my thoughts and I'll go to the most common remedy, at least in our setup, in the African setup here, where um, especially for colds and coughs, almost every parent has a remedy for that. And, you know, some will tell you I get um oranges or lemon, I mix some honey, I put some other natural spices, and it works like magic for my child. And I'm not going to deny that because some things uh are well known that they're going to be very helpful. I'll give an example of honey. So honey is actually a very potent antimicrobial. Uh it works, it really works for coughs and colds. It helps. It's a it's a soother, it soothes the throat, and it does have antimicrobial properties. So it does help. It won't make a big difference, but I think it does help to an extent. And if you look at things like lemon, it's very rich in vitamin C. We know that vitamin C uh helps to boost our immunity against viral infections. Um and so again, that could be helpful. And fruits in general, we always say if your child is sick with a cold, a cough, you know, with a fever, struggling, you know, hydrate them, give them a good serving of fruit, because that really gives them the vitamins and the micronutrients that actually help to boost their immunity and to fight off the cold better. So I think that's the one part. The other part is the balance between the remedies and when to use modern medicines. My general recommendation has always been that for common childhood illnesses that they get very frequently colds and flus and coughs that are not alarming, that are acute, the less the better. You know, manage the fever, hydrate, but be as conservative as possible. Um, but obviously, when there's alarming signs, very high. Great fever, lethargy, inability to feed, then I think there you need to really get help. And that would be to make sure that when there's alarm signs, you really get proper medical help and not rely just on uh uh the local remedies that are um uh a mother's magical portion, it might not work.

SPEAKER_00 22:27

Last question from Munyana from Rhonda. When our baby was born, I was honestly scared to even touch the umbilical cord area. There's so much advice. Don't touch, don't clean it, and leave it alone. What's the safest way to care for it?

SPEAKER_01 22:41

That's an interesting practical question. Um, many parents are very, very anxious around the umbilical cord. So, the first point is that this is a natural process. When a baby is born and we cut the cord and we we tie the stump, the first couple of days is entirely a natural process. All you need is to make sure it's not bleeding, there's nothing unusual, it doesn't have a bad smell, and you do not need to do much about it. If you want, you can use clean water or maybe normal saline to just wipe around it. But generally, you do not need to do much about it because I've seen parents who use uh alcohol or antibacterial solutions to clean it as if it has a problem. And yet this is a natural process. And actually, it's important to note that for the umbilical cord to dry and drop off and heal, the baby needs to be obviously healthy and has a good immune system. But the good bacteria that I spoke about in our discussion around antibiotics play a role in the natural healing and drop-off of the umbilical. So when you become overzealous and you're cleaning it with all kinds of things, you actually risk to delay the healing and the natural process. So just let it be. Within seven to ten days after birth, it's gonna drop off, and that's it. So often than not, it's it's a source of uh unnecessary anxiety. Obviously, if it's bleeding or if it has uh discharge or has a foul smell, and maybe it's getting into what we call an omphalitis, which is an infection of the umbilical stump, uh, or it drops off and you can see that it still stays wet, then it's always good to consult and make sure that you do not require something specific for your baby. Thank you for listening to Healthy Beginnings. If you have any questions you'd like answered in the next episode, you can submit them to our email, healthybeginningspodcast at gmail.com. You can also follow us on all social media platforms. You can find us on YouTube as well as the audio platforms of your choice. See you next week.

SPEAKER_00 25:28

This podcast is for general informational and educational purposes only. Do not make health decisions without consulting your doctor. This podcast is brought to you by LF Media, home of Great African podcasts.