antibiotics necessary?

[kriswillems]

My son fell from a chair down on the public street and had eight stitches in the skin of his head (they shaved part of his hair and put the stitches in there)

It's happened 3 days ago.

Now we need to go to the hospital for 10 days to let the nurse clean the wound.

Can't I do that myself? (They said not, why?). They just put some alcohol on there and a new plaster....?

Also he needs to take 2 full bottles of antibiotics which will take 7 days.

The wound looks clean, flat, not swollen, not infected.

Is it really necessary to take so much oral antibiotics (amoxicilline 250 mg, 3 times per day, his weight is 28kg) for something like this?

They also gave paracetamol, but he doesn't feel any pain, so we not used that bottle.

Edited June 13, 2014 by kriswillems

[Sheryl]

In the West, would not give antibiotics for this assuming the wound was clean. I think you can skip it and just keep a close eye on the wound to make sure it isn't getting red and inflamed. Also think you can do daily would care yourself, and I would suggest betadine rather than alcohol.

Stitches will need to come out in 7-10 days, that part you'd probably do well to have the nurses do.

What hospital was this?

[Marcel1]

Well, the docters studied for it and me not but, I would do it myself, if everything looks clean and your son does not feel pain it should be fine imo.

The Thais obession for medics makes me always confused, I never used medics much in my life and am never sick also.

Had a headwound once when I was 8, a piece of dirty wood fell on my head when building a tree house 6 stiches and my dad cleaned it, had one paracetamol in the evening and day after was fine, even pullled out the stiches myself after a few days when it got itchy.

[ClutchClark]

In the West, would not give antibiotics for this assuming the wound was clean. I think you can skip it and just keep a close eye on the wound to make sure it isn't getting red and inflamed. Also think you can do daily would care yourself, and I would suggest betadine rather than alcohol.

Stitches will need to come out in 7-10 days, that part you'd probably do well to have the nurses do.

What hospital was this?

So are you suggesting she discontinue the course of antibiotics before it is complete?

[trd]

Disclaimer. This does not constitute professional advice.

The over prescription of antibiotics is leading to their ineffectiveness and putting the future of us all in jeopardy. If there is no infection just keep the wound clean. You would expect some swelling around any wound. I don't see the need to take antibiotics unless there is an adverse reaction. Keep a check and make sure your son's temperature is normal. A fever would be a danger sign. Docs here hand out antibiotics like sweeties. The body has its own effective immune system that copes most of the time.

[rhythmworx]

I would use 99.9% isopropanol before the iodine/betadine personally, you can probably get iso-wipes from any pharmacy.

[trd]

If you have started a course of antibiotics you should always fully complete it.

[Tolley]

Totally unnecessary to take antibiotics for a wound like that.

And much better off putting pawpaw ointment or calendula cream on it for healing along with rosehip oil.

[kriswillems]

We went to Somdej Sriracha (government hospital).

The service was excellent, fast and for free. People were kind and professional.

But I was surprised by the amount of antibiotics he got for something simple like this.

Thanks you for your advice.

I think we'll stop after the first bottle.

The believe that something terrible will happen if you stop using antibiotics before the bottle/box is empty even if the infection is long gone is probably an urban legend.

I read a report from the university of Gent, Belgium, which statistically could show this is not true. However, according to the report, one should not stop using the antibiotics before the infection is mostly gone.

Edited June 14, 2014 by kriswillems

[AyG]

I think we'll stop after the first bottle.

The believe that something terrible will happen if you stop using antibiotics before the bottle/box is empty even if the infection is long gone is probably an urban legend.

The problem is not with the patient, but with any surviving bacteria. Those surviving are those most resistant to the antibiotic concerned. This can, in the long term, lead to widespread antibiotic resistance. The full course is designed to kill all of the target bacteria, so resistance can't arise.

Antiobiotic resistance has become a serious problem, with strains of bacteria being resistant to multiple antibiotics making infection harder to treat.

[h90]

If you have started a course of antibiotics you should always fully complete it.

No!!

You should complete it, so some leftovers from your infection can't build resistance to the antibiotics.

If there is no infection there is no reason to continue.

And with "always" it would mean someone who is allergic to antibiotics must continue, no matter if he dies from the allergic problem....

[h90]

I think we'll stop after the first bottle.

The believe that something terrible will happen if you stop using antibiotics before the bottle/box is empty even if the infection is long gone is probably an urban legend.

The problem is not with the patient, but with any surviving bacteria. Those surviving are those most resistant to the antibiotic concerned. This can, in the long term, lead to widespread antibiotic resistance. The full course is designed to kill all of the target bacteria, so resistance can't arise.

Antiobiotic resistance has become a serious problem, with strains of bacteria being resistant to multiple antibiotics making infection harder to treat.

yes but here no infection happened so it is pointless to continue. Unfortunately it is very common in Thailand....Someone feel sick (flu?) get a pack of tablets in the pharmacy. Eat some. Next day it is better he stops. 2 days later it is worse again he eat again some antibiotics....etc etc

[h90]

We went to Somdej Sriracha (government hospital).

The service was excellent, fast and for free. People were kind and professional.

But I was surprised by the amount of antibiotics he got for something simple like this.

Thanks you for your advice.

I think we'll stop after the first bottle.

The believe that something terrible will happen if you stop using antibiotics before the bottle/box is empty even if the infection is long gone is probably an urban legend.

I read a report from the university of Gent, Belgium, which statistically could show this is not true. However, according to the report, one should not stop using the antibiotics before the infection is mostly gone.

To finish the antibiotics is to kill all the target bacteria and not giving them a chance to develop some resistance, via selection of these that could handle the antibiotics best.

But if there is no infection there is no problem.

If you do have an infection you should continue until the infection is COMPLETE gone (not mostly).

[kriswillems]

What I remember from the report, it that if there would be a few remaining bacteria (but the main infection is gone), our immune system is strong enough to handle them.

The report actually advised again the use of antibiotics for 10 days, if the infection is gone after 3 days, because of the negative effects of the antibiotics on our body.

I think the main reason why we're told to take the box until empty is that we're not doctors, and we might not be able to judge when the infection is gone.

Anyway, I was not sure if antibiotics were necessary in this case (luckily we don't have this kind of accident every day), and it looks like they are not, because there never was an infection.

Thanks for your advice Sheryl and others. I'll keep a close eye on it, but it doesn't look like it's going to infect (no signs of it at all).

Edited June 14, 2014 by kriswillems

[stubuzz]

A trip to the hospital usually ends up with a course of antibiotics, needed or not. I was given some for a fungal infection on my toe!

[kriswillems]

yeah, a fungal infection is pretty innocent and it's pretty easy to use common sense in this case.

In the 6 years in Thailand, each and every time someone of my family went to any hospital around, for any problem, we always got amoxicilline and paracetamol (and sometimes also a few other medicines).

But if you fall with your head on the concrete of a public street, with street dogs, (so which probably has a lot of bacteria on it) it's hard to decide yourself is antibiotics were necessary or not, especially when you're not a doctor.

[Tolley]

I think this thing of not finishing your antibiotics is way over hyped.

Countless numbers never do and I don't see any dire consequences from it.

[ClutchClark]

We went to Somdej Sriracha (government hospital).

The service was excellent, fast and for free. People were kind and professional.

But I was surprised by the amount of antibiotics he got for something simple like this.

Thanks you for your advice.

I think we'll stop after the first bottle.

The believe that something terrible will happen if you stop using antibiotics before the bottle/box is empty even if the infection is long gone is probably an urban legend.

I read a report from the university of Gent, Belgium, which statistically could show this is not true. However, according to the report, one should not stop using the antibiotics before the infection is mostly gone.

To finish the antibiotics is to kill all the target bacteria and not giving them a chance to develop some resistance, via selection of these that could handle the antibiotics best.

But if there is no infection there is no problem.

If you do have an infection you should continue until the infection is COMPLETE gone (not mostly).

And how do you know if there is an infection? Short answer--you don't.

OP, please don't listen to any one posting here if they are not a medical professional. If you feel you were over-prescribed anti-biotics then find a new doctor and have them make the determination but why in the world would you place your child's health in the hands of some anonymous people on an internet forum that have no medical training and have not even seen your child?

Where is Cheryl? She is the one who started the OP down this oath that is against all medical wisdom to stop a course of anti-biotics before it is finished.

[ClutchClark]

I think this thing of not finishing your antibiotics is way over hyped.

Countless numbers never do and I don't see any dire consequences from it.

Thank you for tat opinion.

Now please do describe your medical training to all of us here since you are providing information that can directly affect the health and welfare of a child.

[trd]

If you have started a course of antibiotics you should always fully complete it.

No!!

You should complete it, so some leftovers from your infection can't build resistance to the antibiotics.

If there is no infection there is no reason to continue.

And with "always" it would mean someone who is allergic to antibiotics must continue, no matter if he dies from the allergic problem....

You said No but then agreed with me. Confusing. If the course is not completed, bacteria can develop resistance and lead to secondary infection. Normally this would facilitate change to a different antiobiotic.

It was not implicit in my remark that you continue if allergic as you seem to suggest. A doctor should ask about allergies before prescribing.

Edited June 14, 2014 by trd

[trd]

I think this thing of not finishing your antibiotics is way over hyped.

Countless numbers never do and I don't see any dire consequences from it.

That is a completely irresponsible remark. What exactly is it that you "don't see as dire consequences" in terms of empirical data?

[AyG]

I think this thing of not finishing your antibiotics is way over hyped.

Countless numbers never do and I don't see any dire consequences from it.

Overhyped? Hardly. No dire consequences? They're there in spades.

- Wound infections, gonorrhea, tuberculosis, pneumonia, septicemia and childhood ear infections have all have become hard to treat with antibiotics.

- Nowadays, about 70 percent of the bacteria that cause infections in hospitals are resistant to at least one of the drugs most commonly used for treatment.

- Some organisms are resistant to all approved antibiotics and can only be treated with experimental and potentially toxic drugs.

- In a recent study, 25% of bacterial pneumonia cases were shown to be resistant to penicillin, and an additional 25% of cases were resistant to more than one antibiotic.

Source: http://textbookofbacteriology.net/resantimicrobial.html

[h90]

What I remember from the report, it that if there would be a few remaining bacteria (but the main infection is gone), our immune system is strong enough to handle them.

The report actually advised again the use of antibiotics for 10 days, if the infection is gone after 3 days, because of the negative effects of the antibiotics on our body.

I think the main reason why we're told to take the box until empty is that we're not doctors, and we might not be able to judge when the infection is gone.

Anyway, I was not sure if antibiotics were necessary in this case (luckily we don't have this kind of accident every day), and it looks like they are not, because there never was an infection.

Thanks for your advice Sheryl and others. I'll keep a close eye on it, but it doesn't look like it's going to infect (no signs of it at all).

Sometimes infection that appear to be complete gone can come back. Surely mostly our immune system is strong enough. But it is better to continue a bit longer.

I recall before was the recommendation in my country: finished infection + 3 days. Than the American system came, assuming that people don't know when the infection is gone, telling a simple 10 days. Next was assuming people can't count to 10, so telling till the pills are finished....

[h90]

We went to Somdej Sriracha (government hospital).

The service was excellent, fast and for free. People were kind and professional.

But I was surprised by the amount of antibiotics he got for something simple like this.

Thanks you for your advice.

I think we'll stop after the first bottle.

The believe that something terrible will happen if you stop using antibiotics before the bottle/box is empty even if the infection is long gone is probably an urban legend.

I read a report from the university of Gent, Belgium, which statistically could show this is not true. However, according to the report, one should not stop using the antibiotics before the infection is mostly gone.

To finish the antibiotics is to kill all the target bacteria and not giving them a chance to develop some resistance, via selection of these that could handle the antibiotics best.

But if there is no infection there is no problem.

If you do have an infection you should continue until the infection is COMPLETE gone (not mostly).

And how do you know if there is an infection? Short answer--you don't.

OP, please don't listen to any one posting here if they are not a medical professional. If you feel you were over-prescribed anti-biotics then find a new doctor and have them make the determination but why in the world would you place your child's health in the hands of some anonymous people on an internet forum that have no medical training and have not even seen your child?

Where is Cheryl? She is the one who started the OP down this oath that is against all medical wisdom to stop a course of anti-biotics before it is finished.

a ) If you can't judge on a cut on the skin if it is infected or not, without a professional than you have a much more serious problem....

b ) we speak here about a cut of the skin, which people could handle the last thousands of years without any problems. We are not speaking about liver cancer. A small injury on a healthy kid, like most kids have and some kids have hundred times....

[h90]

If you have started a course of antibiotics you should always fully complete it.

No!!

You should complete it, so some leftovers from your infection can't build resistance to the antibiotics.

If there is no infection there is no reason to continue.

And with "always" it would mean someone who is allergic to antibiotics must continue, no matter if he dies from the allergic problem....

You said No but then agreed with me. Confusing. If the course is not completed, bacteria can develop resistance and lead to secondary infection. Normally this would facilitate change to a different antiobiotic.

It was not implicit in my remark that you continue if allergic as you seem to suggest. A doctor should ask about allergies before prescribing.

You are getting a bit ridiculous.....here is no infection, so no secondary infection.

Even if there is an infection and you stop the antibiotics the chance that a resistance is developed is extreme low, almost zero. Just as we have billions of people the very low chance happens sometimes. But I doubt it happens in such cases often. It happens mostly in hospitals, it happens where antibiotics are mixed in animal food. Maybe also were antibiotics are just mixed into the normal junk. Always in my country when I was young the doctors told: finished infection than continue for 3 days. When it was good in 3 days, you stopped after 6 days. Worked for decades.....

You told: "If you have started a course of antibiotics you should always fully complete it." The doc should ask.....and who knows about allergies to antibiotics? If you are healthy you don't need antibiotics so how would you know?

I don't get the point of feeding people with antibiotics if they have no infections or just some minor small red spot.

[Sheryl]

Since the poster asked if he needed to give the antibiotics I assumed her had not yet done so.

If by chance he has already given them then should complete at least 5 full days (the minimum course) as indeed there is otherwise a risk of the bacteria normally found on the skin (which are what usually infect wounds) becoming resistant which could cause problems later.

[trd]

If you have started a course of antibiotics you should always fully complete it.

No!!

You should complete it, so some leftovers from your infection can't build resistance to the antibiotics.

If there is no infection there is no reason to continue.

And with "always" it would mean someone who is allergic to antibiotics must continue, no matter if he dies from the allergic problem....

You said No but then agreed with me. Confusing. If the course is not completed, bacteria can develop resistance and lead to secondary infection. Normally this would facilitate change to a different antiobiotic.

It was not implicit in my remark that you continue if allergic as you seem to suggest. A doctor should ask about allergies before prescribing.

You are getting a bit ridiculous.....here is no infection, so no secondary infection.

Even if there is an infection and you stop the antibiotics the chance that a resistance is developed is extreme low, almost zero. Just as we have billions of people the very low chance happens sometimes. But I doubt it happens in such cases often. It happens mostly in hospitals, it happens where antibiotics are mixed in animal food. Maybe also were antibiotics are just mixed into the normal junk. Always in my country when I was young the doctors told: finished infection than continue for 3 days. When it was good in 3 days, you stopped after 6 days. Worked for decades.....

You told: "If you have started a course of antibiotics you should always fully complete it." The doc should ask.....and who knows about allergies to antibiotics? If you are healthy you don't need antibiotics so how would you know?

I don't get the point of feeding people with antibiotics if they have no infections or just some minor small red spot.

It is you who is being ridiculous. The OP started his son on the antibiotics before posting. You say there is no infection. You don't know that. I already advised not to take them for a superficial flesh wound, but as he already started he should finish. When antibiotics kill bacteria, the last ones to perish are the most resistant. This is natural selection at work. If the course is stopped prematurely, the most resistant survivors can go on to cause a secondary infection in a different site. Hospitals have a different problem with MRSA and others in an opportunist environment such as post surgery.

Assuming this air of authority by putting others down with such comments just diminishes your credibility.

Edited June 14, 2014 by trd

[ClutchClark]

Since the poster asked if he needed to give the antibiotics I assumed her had not yet done so.

If by chance he has already given them then should complete at least 5 full days (the minimum course) as indeed there is otherwise a risk of the bacteria normally found on the skin (which are what usually infect wounds) becoming resistant which could cause problems later.

Thank you for clarifying. Thats the expertise I had expected.

[ClutchClark]

We went to Somdej Sriracha (government hospital).

The service was excellent, fast and for free. People were kind and professional.

But I was surprised by the amount of antibiotics he got for something simple like this.

Thanks you for your advice.

I think we'll stop after the first bottle.

The believe that something terrible will happen if you stop using antibiotics before the bottle/box is empty even if the infection is long gone is probably an urban legend.

I read a report from the university of Gent, Belgium, which statistically could show this is not true. However, according to the report, one should not stop using the antibiotics before the infection is mostly gone.

To finish the antibiotics is to kill all the target bacteria and not giving them a chance to develop some resistance, via selection of these that could handle the antibiotics best.

But if there is no infection there is no problem.

If you do have an infection you should continue until the infection is COMPLETE gone (not mostly).

And how do you know if there is an infection? Short answer--you don't.

OP, please don't listen to any one posting here if they are not a medical professional. If you feel you were over-prescribed anti-biotics then find a new doctor and have them make the determination but why in the world would you place your child's health in the hands of some anonymous people on an internet forum that have no medical training and have not even seen your child?

Where is Cheryl? She is the one who started the OP down this oath that is against all medical wisdom to stop a course of anti-biotics before it is finished.

a ) If you can't judge on a cut on the skin if it is infected or not, without a professional than you have a much more serious problem....

b ) we speak here about a cut of the skin, which people could handle the last thousands of years without any problems. We are not speaking about liver cancer. A small injury on a healthy kid, like most kids have and some kids have hundred times....

You are diagnosing and giving medical advice to a child for an injury that you have not seen.

So, yes, we have a serious problem.

Now please read the post by Cheryl, who does happen to be a medical professional with 30 years experience.

[rsokolowski]

Once you start taking a course of antibiotics you need to take the entire course (every last pill, every time). Stopping an antibiotic course is one of the primary reason that there are strains of TB that do not respond to antibiotics.