Antibiotics treat infections caused by bacteria. They do nothing for viruses, and most childhood coughs, colds, sore throats, tummy bugs and fevers are caused by viruses. So when a pediatrician says your child does not need an antibiotic, it usually means the illness will pass on its own and that an antibiotic would bring side effects without any benefit. Some infections do need antibiotics, and the doctor decides which by examining your child.

What is the difference between a virus and bacteria?

Viruses and bacteria are both germs, but they are different kinds of germ, and the medicines that work on one do not work on the other.

Viruses
cause colds, flu, most coughs, most sore throats, croup, bronchiolitis, chickenpox, hand, foot and mouth disease and most tummy bugs. They clear with time, rest and fluids.
Bacteria
cause infections such as strep throat, some ear and sinus infections, urinary tract infections, some chest infections and some skin infections. These sometimes need antibiotics.

The two can look alike at the start. A sore throat, a cough or a fever can be either, which is why the doctor looks at your child rather than going by the symptoms alone.

Why won’t the doctor prescribe an antibiotic for a cold?

Because it would not help, and it can harm. An antibiotic given for a virus does not shorten the illness. It can cause diarrhoea, rashes, tummy pain and thrush. Each unnecessary course also makes it more likely that bacteria become resistant, so that the medicine works less well when your child really needs it. Resistance is a recognised public health problem, and the NHS explains it clearly.

Green or yellow mucus, a fever of a few days and a cough that lingers do not by themselves mean bacteria. Colds often last 10 days or more, and the mucus changes colour as the body fights the virus.

Which infections may need antibiotics?

The doctor may prescribe one when an examination or a test points to a bacterial cause, for example:

  • strep throat, confirmed by a throat swab
  • a urinary tract infection
  • bacterial pneumonia
  • some ear infections, depending on age, symptoms and how unwell the child is
  • some skin infections
  • other bacterial infections found on examination

Ear infections are a good example of how the decision varies. In many older children, a mild ear infection gets better without an antibiotic, and the doctor may suggest pain relief and review in a day or two. In babies and in children who are very unwell, the doctor is more likely to prescribe straight away. Our guides on ear infections and strep throat and tonsil infections explain more.

How does the doctor decide?

A pediatrician looks at how long your child has been ill, how they look and behave, the fever pattern, what the ears, throat and chest show, and your child’s age and other conditions. Sometimes a quick test helps, such as a throat swab, a urine test or a blood test. If the picture is unclear, the doctor may give you a plan to watch and review, with clear signs for when to come back sooner.

What can I do instead when no antibiotic is needed?

  • Give fluids little and often. Offer breast milk or formula to babies.
  • Let your child rest, and do not force food.
  • Ask the doctor about paracetamol or ibuprofen for pain or discomfort, at the dose that suits your child’s age and weight. See our guide to fever reducers.
  • Use saline drops and a bulb syringe for a blocked nose in a baby.
  • Raise the head of the bed slightly for an older child with a cough, if the doctor agrees.
  • Keep your child home while they have a fever.

Do not give cough or cold medicine to young children unless the doctor advises it.

How do I give antibiotics safely when they are prescribed?

  • Give the full course, at the times and dose written on the label, even if your child seems better after a day or two. If you think a dose has been missed, ask the pharmacist or doctor what to do.
  • Use the measuring syringe or spoon supplied, not a kitchen spoon.
  • Do not keep leftovers or use them for a later illness, and do not give your child someone else’s antibiotic.
  • Antibiotics are prescription medicines in the UAE, so ask the doctor rather than a pharmacy counter.
  • Tell the doctor about any previous reaction, rash or allergy to a medicine.
  • Ask whether to give the medicine with food, and whether it should be kept in the fridge.

Mild diarrhoea or a loose stool is common. A rash, swelling of the lips or face, or difficulty breathing is not, and needs urgent care.

When to see a doctor

See a pediatrician the same day if your child:

  • has a fever for more than three days, or a fever that goes away and comes back
  • has ear pain, a painful throat or a cough that is getting worse
  • is breathing faster than usual or seems to be working hard to breathe
  • is drinking much less than normal or passing much less urine
  • is unusually sleepy, irritable or floppy
  • is getting worse instead of better after a few days

Call 998 or go to an emergency department for a baby under 3 months with a fever, for difficulty breathing, for a stiff neck or a rash that does not fade when pressed with a glass, or for a child who is hard to wake. Our guide to the ER or the pediatrician helps you decide.

How we can help at myPediaclinic

Dr. Tala Belbeissi, Consultant Pediatrician, and Dr. Medhat Abu-Shaaban, Consultant Pediatrician and Medical Director, see children with coughs, fevers, sore throats and ear problems through our pediatric check-ups. We examine your child, explain whether the illness is likely viral or bacterial, prescribe an antibiotic when it is needed, and tell you plainly when it is not and what to do instead. Consultations at our clinic in Dubai Healthcare City are available in English and Arabic.

Frequently asked questions

Why does my child have a fever if antibiotics are not needed?

A fever is the body’s response to infection, and viruses cause it as often as bacteria do. The fever itself is not a reason for antibiotics. What matters is how your child looks and acts, and what the doctor finds on examination.

Can I ask for an antibiotic “just in case”?

It is reasonable to ask the doctor to explain the decision. An antibiotic given just in case does not prevent a bacterial infection, and it can cause side effects. A better plan is a clear list of signs for coming back, and a review if your child does not improve.

Should I stop the antibiotic when my child feels better?

Finish the course the doctor gave you unless the doctor tells you otherwise. If your child has a reaction or you are worried, speak to the doctor before stopping.

Do probiotics help during an antibiotic course?

Some doctors suggest them to ease loose stools, but evidence varies by product. Ask your pediatrician what is suitable for your child. See our guide to probiotics for children.

Is it safe to take the same antibiotic again next time?

Not without checking. Each illness needs its own assessment, and the right medicine and dose depend on the infection and your child’s weight. Tell the doctor which antibiotics your child has had before.

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