Parents can’t resist asking me if their child would benefit from an antibiotic when they are sick. So let me prescribe some advice about why we do and do not like to use antibiotics.

Just over 40 percent of outpatient prescriptions are for antibiotics, and yet, half of these turn out to be unnecessary.

Why? Antibiotics were designed to effectively treat bacterial germs that get into the body. But the majority of childhood illnesses — or “colds” — are not due to bacterial germs but to viral germs or viruses. These viruses don’t respond to antibiotics. They often go away in a few days with supportive care such as acetaminophen and good hydration. This is why antibiotics cannot help children recover from the common cold.

Using antibiotics when we strongly suspect a child has a virus can lead to a big problem called antibiotic resistance. This happens when antibiotics are used so often that bacterial germs develop resistance to these common, and very effective, medicines. That antibiotic resistance could make it very difficult to treat these bacteria in the future.

So, what do I recommend?

1. Don’t insist on an antibiotic every time your child is ill. Colds, sore throats, stomach aches, flu symptoms and even ear infections are usually due to viruses, not bacteria. If you are concerned about your child being sick, have them seen by your child’s health-care professional. They can best determine if an antibiotic is warranted. If not, they will give you suggestions to make your child comfortable until a virus passes.

2. Use antibiotics as prescribed for your child and only for as long as prescribed. If you have some left at the end of a course, do not save them for the next time your child is sick. That can contribute to antibiotic resistance.

3. Never use someone else’s prescription.

4. Taking antibiotics is not the best way to prevent getting an infection. Practice good hand washing, be sure your child stays up to date on immunizations and keep your child out of school when sick. That way, viral or bacterial germs cannot spread.

Hopefully, tips like these will be ones you cannot resist when knowing about why and why not to use antibiotics.

Dr. Lewis First is chief of pediatrics at The University of Vermont Children’s Hospital and chair of the department of pediatrics at the University of Vermont College of Medicine.

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