Q: Are there any studies on long-term effects of taking antibiotics?
A: We are unaware of studies that demonstrate any significant adverse effects from taking antibiotics over a long period of time, assuming that these medications are taken under a physician's supervision for a specific indication.
For example, until recently, adolescents with acne were safely treated by taking tetracycline for months and even years. (Recent advances in acne therapy have almost eliminated the need for this particular approach.) We do not advocate, however, that individuals self-medicate with leftover or borrowed pills or that parents use one child's antibiotic to treat a sibling with what appears to be a similar illness.
Some diseases, such as sickle cell anemia and cystic fibrosis, often require the use of daily antibiotics for years to prevent common infections that could worsen the underlying disease.
Children with very frequent ear or urinary tract infections will benefit from daily antibiotics to cut down on the number of recurrences. In these situations, the advantages of long-term use far outweigh any potential side effects from the antibiotics.
Any medication can have side effects. Your physician will carefully explain to you why your child needs to take antibiotics for an extended period and what side effects should prompt concern.
If you are unsure, you should not hesitate to discuss the matter further with him or her. Once your child is old enough to understand the discussion, he or she should be involved as well. In that way, your child is more likely to be willing to go along. This is especially so for teen-agers, since independence and being in control are important issues at this stage in their development.
Dr. Wilson is director of pediatric primary care of the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.