“What are the most effective antibiotics for children?”

What antibiotic is chosen is based on the specific bacteria that is being treated, the location of the infection, and other considerations. There is no "one size fits all" for any age group.

Shelley C. Springer, MD, MBA, MSc, JD, FAAP

This is a difficult question to answer because the answer is, it depends on the illness! Most childhood illnesses are viral and require no antibiotics for treatment because antibiotics cannot cure or fight a virus. That said, remember that many of the most serious of childhood illnesses that are viruses are preventable with vaccines that are given in early infancy such as Measles, Mumps, Chicken Pox, Polio, etc. As far as the bacterial illnesses that can and should be treated with antibiotics (ABX), it is best to test first and choose an appropriate ABX for the disease. Streptococcal pharyngitis (strep throat) is usually treated best with penicillin; orally, a liquid, pills or occasionally an injection. Community acquired pneumonia, may require a two drug regimen. Many physicians treat it initially with amoxicillin or augmenting plus erythromycin initially while awaiting blood cultures for predominant organisms or even ceftriaxone intravenously. Once the organism and its sensitivity is known, the physician can switch to oral medications that can treat the child and move treatment out of the hospital and to the home. Urinary tract infection should not be treated until an organism is known! This usually takes less than 48 hours. The fever can be controlled with antipyretics and the discomfort with cranberry juice and other comforting things. Activities that avoid urinary tract infections: wiping after defecation improperly, bubble baths, proper hygiene, etc., is the most important thing in avoiding UTIs in childhood. If your 6 year old is ill, it is best that the child is seen by their physician and evaluated to determine if their illness is viral or bacterial. Viral illnesses require no antibiotics because they are of no value. If the disease is bacterial, the cause should be determined and the appropriate ABX should be prescribed.
I hope this reply has been helpful.

Alexander R. Horowitz, MD, FAAP

Antibiotics are chosen based on the age of the child and the type of infection. In addition, each community publishes information for providers on the resistance patterns in that particular community. For instance, in some communities, there is very high resistance to azithromycin. Other communities may have low resistance so azithromycin is a good choice. The current recommendation is that Ear Infections be treated first the Amoxicillin at a high dose of 80mg per kg in two divided doses. Skin infections may be treated with cephalexin or
trimethoprim/sulfamethoxazole. Other common antibiotics are Augmentin and Omnicef. If you have questions about why your provider is choosing a particular antibiotic for your child, ask them. Understanding the risks and benefits of treatments is your right as a parent.