A patient was seen for three days for headache and generalized aches and pains, without fever, and it was assumed that the registration office was alert and recommended a neurology visit. The history also included a slight sore throat and cough, and the examination revealed no muscle weakness or pressure, and no signs of meningeal irritation. The blood picture had normal white blood cells and a low neutral classification. The patient said that he had been taking azithromycin since the first day of discomfort and had been feeling nauseous for the last few days. In my preliminary judgment, the patient was likely to have a generalized headache caused by upper sensation and a gastrointestinal reaction due to the use of antibiotics. After performing the necessary exclusion tests, I recommended that the patient stop taking azithromycin, rest, drink plenty of fluids, and take acetaminophen for symptomatic treatment.
The science of antibiotic use is old hat, but it seems there is always a place where the sun doesn’t shine. If you are exposed to the above science, you may say that using antibiotics without even having a high temperature is a bit much. But here is a different topic: should you use antibiotics if you have a high temperature?
Last month, my daughter had a cold with a maximum fever of 42 degrees for six days, and all I gave her was antipyretics and physical cooling. Even my colleagues and friends who are doctors could not help but persuade me to use antibiotics in those days, and I was almost swayed. My husband, who is not a doctor, supported me and trusted me, telling me to trust my own judgment.
Afterwards, my friends said, “You’re really holding up well! I was actually not blindly holding on.
First, although the child’s fever was high, the fever medicine was able to go down, and the number of fever-reducing medications used per day gradually decreased (from three times a day to twice a day to only once a day for the first three days).
Second, the child had a good appetite, ate more or less every meal, drank water, and urinated quite often.
Third, in the process of gradually decreasing body temperature, other symptoms did not tend to worsen, such as a mild cough and a small amount of white sputum. The first three days of observation, the temperature has been completely normal, the fourth day we went out to a Christmas party, the results of the next day to school temperature rose again to more than 38.5. We had to rest at home for a day, and we were not allowed to do any homework. In this way, the natural course of the disease ended after only one day.
A classmate in my daughter’s class, both of whom had the same illness on the same day, had the exact same symptoms and started taking antibiotics from the first day of the fever, including cephalosporin and aci, and studied two days later than my daughter. So, antibiotics do not change the course of the cold.
To deal with fever caused by a cold, you only need to master three principles.
First, control the body temperature. The reason why I say control is that the body temperature is not necessarily down to normal (below 37 degrees). Generally over 38.5 degrees before the use of antipyretic drugs, but 42 degrees of body temperature alone with antipyretic drugs is very difficult to drop to normal, can be reduced to 39 degrees, also indicates that antipyretic drugs are effective. What about the part that still exceeds? Physical cooling!
Do not underestimate the physical cooling, which is absolutely seemingly a powerful trick, but many people do not know how to do. The following shares a few “secrets” of physical cooling: 1, use warm water baths, rather than ice water or alcohol. This is because warm water does not irritate the skin and expands the local pores, which is more conducive to the discharge and evaporation of sweat. 2, rub the large arteries (such as the neck, the root of the thighs) and the heart of the hands and feet. Only put a wet towel in the brain can only make the patient feel comfortable, the brain felt cool, body temperature did not drop, in fact, is self-deception. 3, in the neck, armpits and occipital placement of ice bags. Cool cans, mineral water bottles are also available, wrapped with a thin towel to avoid direct stimulation of the skin. 4, in the mouth with ice or lozenges. The gas exhaled from the mouth and nose is hot when you have a fever, so lowering the temperature of the respiratory tract will help you breathe smoothly and sleep smoothly. 5, along with an adequate amount of fluid intake. When you have a fever, the body’s unexplained water loss increases significantly, and dehydration disrupts organ functions, which is one of the main causes of cold complications. The most direct and reliable indicator is the decrease in the number of urinations per day compared to the usual. It is important to give the child water or juice on a regular basis, and if water cannot be consumed, the only way to replace the loss of fluids is through infusions.
Second, diet, rest and care. When you have a fever, it is advisable to have a light diet, and clear porridge and salty vegetable soup are suitable. You may think that you need good nutrition at this time, but when you have a fever, the mucous membrane of the gastrointestinal tract is bruised, and you have a poor appetite and reduced digestive capacity, so too much fatty food will increase the burden on the gastrointestinal tract. It is common to feel weak and tired, so how can we replenish our strength?
The best way is to add sugar to the body, and starchy foods are the most direct. Therefore, light rice porridge and rice soup can replenish both sugar and B vitamins. If you want to add protein, you can make egg custard. An egg with an equal amount of warm water, steamed and soft, is a very good diet for fever patients. Eat less and more, don’t force yourself to eat more, and sleep when you are tired. When you have a cold, your strength decreases and you need to reduce your work and study load to give your body sufficient rest. Some parents who are concerned about their children and do not know how to control them, feel sorry for their children who are sick, and usually do not allow to play ipads are sent to the hands. When the child is in good spirits, the game is played too much and the child is not well rested, and the disease is likely to recur. As a parent and chaperone, you should know that eliminating distractions and ensuring rest are also part of the care. Other care includes rinsing the mouth with mouthwash or warm salt water, and changing wet underwear in a timely manner.
Third, seek medical attention if necessary. A fever is a reflection of the body’s resistance to viruses or bacteria, and is a signal that a “battle” has been fought, with the degree of fever indicating the severity of the battle. Believe that the human body is capable of self-repair after years of evolution and testing. Premature and excessive interventions will not shorten the course of the disease (as in the case of my daughter’s classmate), but may even cause unnecessary problems (as in the case of the patient at the beginning). In addition, hospitals are places where viruses and bacteria are easily concentrated, and when you have a fever, your resistance is already reduced, so going there may increase the chance of new infections. Therefore, I usually do not take my children to the hospital for the first three days of a fever, as long as their temperature does not continue to drop. However, if the temperature does not drop, the child is severely dehydrated, has difficulty breathing, and continues to be lethargic, it is necessary to seek medical attention. In the hospital, blood and imaging tests can be done to determine the cause of the illness and provide the appropriate treatment. However, even in severe fevers, the first two principles of management are still taken into account and implemented in the hospital.
At this point, the question posed in the title has been answered. Still, it is not always necessary to use antibiotics for fever. I heard about an elderly doctor who was punched by a parent because the child’s parents strongly requested “anti-inflammatory drugs” and the doctor did not think they were necessary. It was heartbreaking to hear about this, not only for the injured bodies and minds of their peers, but also for the ignorance of the parents! Disease is a product of nature and is an enemy that doctors and patients need to face together. Only when both sides work together and follow the objective laws can mankind be invincible in the long-term struggle with disease. The work of science popularization is still a long way to go!
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