So, your child is sick, and you think they need antibiotics. If you were hoping to run to the store and grab antibiotics that will get them back to 100%, I have some not-so-great news to share: generally speaking, you cannot get antibiotics over the counter. 

Over the counter, you can get many topical antibiotics/antimicrobials, such as ointments or creams like Neosporin. However, any medications needed by mouth for a bacterial infection need a doctor's prescription.

So, if your kiddo has a scrape, you can try ointment without needing a doctor to intervene. But if your child has a more serious cut or is displaying signs of a possible infection, then you may need an oral antibiotic.

When are antibiotics needed?

Antibiotics are used to treat bacterial infections. Bacteria are the culprit behind strep throat, whooping cough, urinary tract infections, and some ear infections. If your child is experiencing symptoms due to a viral infection - like COVID, the common cold, and the flu - then antibiotics aren’t helpful (and won't do anything to speed up their healing process). The only way to know if an infection is bacterial or viral is through a doctor's diagnosis. (But most infections your child will experience are caused by viruses!)

Why are antibiotics prescription-only drugs?

There are three primary reasons you cannot get an antibiotic over the counter, and it all boils down to safety and avoiding antibiotic misuse.

1. Antibiotics are designed to treat bacterial infections

Antibiotics were designed to kill or stop the growth of harmful bacteria that enter the body; they have zero impact on viral infections, a more common source of illness.

And even when antibiotics are needed, only certain antibiotics can effectively treat specific illnesses. Visiting your family's doctor for proper diagnosis and treatment ensures the correct antibiotic is prescribed. They can also assess if another course of treatment is recommended, or if antibiotics are not needed.

2. Your child's health and safety are most important

The need for prescription-only antibiotics also serves as a safety measure. Some children may have allergies or medical conditions that certain antibiotics could worsen. Antibiotics also occasionally have minor side effects that some children can experience. Lastly, there is a healthy mix of “good bacteria” in each child’s GI tract that antibiotics can disrupt.  A doctor will consider your child's medical history, weigh the benefits and risks, and ensure the healthiest treatment course before prescribing antibiotics (or any medication).

3. Improper use can lead to antibiotic resistance

Another reason a doctor needs to evaluate and prescribe the appropriate type and dosage of antibiotics for each case is antibiotic resistance. Antibiotic resistance occurs when bacteria become immune to the effects of a specific medication (antibiotic-resistant bacteria), making it less effective over time and increasing the potential for widespread resistance in our communities. A few forms of antibiotic misuse include:

• Prescribing or taking antibiotics for viral infections
• Prescribing or taking the wrong antibiotics for a particular illness
• Not completing a full course of antibiotic treatment (always administer antibiotics to completion, even if your child's symptoms improve)

Antibiotic resistance is a serious threat to all of us. Antibiotic-resistant bacteria can spread through communities - and the world - making infections much more difficult to treat and even life-threatening.

What antibiotics are available over the counter?

Ointments and creams are the only antibiotics you’ll find over the counter. These topical antibiotics are used to treat scrapes, wounds, burns, or acne. Multiple generic brands are available, but some names you may recognize are Neosporin, Polysporin, and Proactiv.

If you try any of these for a skin infection on your child and they don’t seem to be working, let your doctor know - there are stronger treatments available that are only offered with a prescription.

What illnesses or infections usually require antibiotics?

Whether your child needs antibiotic treatment boils down to whether the illness is bacterial or viral. Bacterial illnesses or infections need antibiotics; common illnesses that bacteria can cause include:

• Pneumonia
• Urinary tract infections (UTI) - includes bladder or kidney infections
• Strep throat
• Some ear infections
• Some pink eye cases

Viral illnesses or infections generally resolve on their own, or they may require treatment to manage symptoms. Common examples of viral illnesses are:

• Colds
• Sinus infections (can be viral or bacterial)
• Ear infections (can be viral or bacterial)
• Pink eye (can be viral or bacterial)
• COVID-19
• Flu/Influenza
• RSV
• Stomach bugs

There are some heavy hitters on the viral list! Just because an illness is caused by a virus and not a bacteria does not mean it can’t be severe! Treatment is often needed to manage symptoms of those illnesses, but that treatment won’t be antibiotics. Some examples of treatment for viral infections include:

• Rest (one of the most important things to prioritize when sick!)
• Ibuprofen or acetaminophen (for pain, discomfort, fevers)
• Antiviral medication (these are specific to certain viruses)
• Fluids (water, herbal teas, electrolyte drinks)

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When viral infections lead to bacterial complications

It’s important to know that sometimes viral infections can lead to bacterial infections. A good example of this is when your child has a cold. If they have an excess of mucus building up, it can sit stagnant somewhere in a dark place (like their sinus cavity). In that case, bacteria can begin to grow, and they can develop a sinus infection that would then need antibiotics. However, it is still important to only use antibiotics to treat the bacterial infection, not to try to prevent it. (Note: Sinus infections can also be viral, meaning they don’t all need antibiotics. Let your doctor guide you!) 

A general rule of thumb is to reach out to a doctor after a certain number of days if symptoms aren’t improving, depending on the symptoms. Call the doctor…

• If your child has a high fever (>103℉ by mouth) at any time or with any fever lasting more than four days
• If your child’s runny/stuffy nose or cough isn’t improving within 10-14 days
• If your child’s sore throat isn’t improving within 5-7 days
• If your child has any drainage or swelling with their ear pain or if the pain is severe

Commonly prescribed antibiotics for bacterial infections

There are many different bacterial infections, each requiring a specific antibiotic for treatment. Some common antibiotics prescribed to children for bacterial infections include:

• Amoxicillin - ear infections caused by bacteria, strep throat, pneumonia
• AugmentinES, Augmentin  - ear infections caused by bacteria, strep throat, pneumonia
• Bactrim, Sulfatrim - urinary tract infections, ear infections caused by bacteria
• Ciprodex ear drops - swimmer’s ear, ear infections caused by bacteria (kids with tympanostomy tubes)
• Erythromycin Eye Ointment - pink eye caused by bacteria
• Keflex - skin infections, cellulitis, abscess
• Omnicef - ear infections caused by bacteria, pneumonia, strep throat, urinary tract infections
• Ofloxacin Eye Drop - pink eye caused by bacteria, ear infections caused by bacteria (kids with tympanostomy tubes)
• Ofloxacin Ear drops - swimmers ear, ear infections caused by bacteria (kids with tympanostomy tubes)
• Polytrim Eye Drop - pink eye caused by bacteria
• Z-pack, Zithromax - pneumonia, ear infections caused by bacteria, strep throat

Without a proper diagnosis from a doctor, it's impossible to know which antibiotic medication your child needs. Discuss your child’s allergies with their doctor to determine the most appropriate antibiotic and avoid unnecessary side effects or complications.

Can you get antibiotic prescriptions from Blueberry Pediatrics?

We’re so glad you asked! When deemed medically appropriate, Blueberry pediatricians are happy to  write prescriptions for antibiotics to treat the infections and illnesses they diagnose. If you suspect your child has a bacterial infection or have more antibiotic questions, you can chat with a board-certified pediatrician through Blueberry Pediatrics.

Blueberry offers on-demand virtual healthcare for kids ages 0-21, right from the comfort of home. Blueberry's pediatricians are available 24/7/365 through text, video, or call. We treat most childhood symptoms and illnesses; no question is too big or small.

The best part? An entire year of Blueberry membership costs less than the typical copay of a single urgent care visit, and one membership covers all children in your household! It's like a doctor's office in your house. You can sign up here.

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Frequently Asked Questions

Can I buy antibiotics without a prescription?

Generally speaking, you cannot obtain antibiotics without a prescription written by a doctor. You can pick up topical antibiotics, such as Neosporin, for mild scrapes and cuts, which can help your child heal faster. However, your child's pediatrician must prescribe oral antibiotics for bacterial infections and illnesses.

What are the most commonly prescribed antibiotics for children?

Many antibiotics are on the market - a pediatrician can determine which one may be the best treatment for the individual bacterial infection. Some common antibiotics you may hear about are amoxicillin, ciprofloxacin, azithromycin, clindamycin, and doxycycline.

Do antibiotics treat the common cold? Flu?

Antibiotics do not treat the common cold or flu because viruses cause both illnesses. Antibiotics can only treat bacterial infections. Consult a pediatrician if you're unsure if bacteria or a virus causes your child's illness.

Can I get an antibiotic prescription online?

Yes! If you suspect your child has a bacterial infection (like strep throat or a UTI), you can chat with a board-certified pediatrician for diagnosis and treatment through Blueberry Pediatrics. Our pediatricians can write an antibiotic prescription, if medically necessary, for illnesses and infections they diagnose - without you ever leaving your home!