Ask a doctor on the topic of Pediatrics

potential infection with Haemophilus influenzae

April 24, 2016 | 20,00 EUR | answered by Dr. med Ralf von Seckendorff

Dear doctors,

first of all, the facts:
- my wife has had a sore throat and dry cough for about two weeks (occasionally productive).
- The sore throat has come and gone, but is currently back.
- We have been treating with home remedies such as thyme tea and steam inhalation.
- No fever
- Initially she felt flu-like symptoms, but not anymore. However, the cough persists.
- On Tuesday, we did a swab test and found elevated inflammation markers and a high presence of Haemophilus influenzae.
- We have a 6-week-old daughter, who is doing well so far.
- My wife exclusively breastfeeds and has been wearing a mask since Tuesday.
- The general practitioner tested the swab for antibiotic sensitivities and found resistance to the most common antibiotic. The best alternative was found to be Ciprofloxacin hydrochloride, which we have obtained.
- The GP advises to only take the antibiotic if symptoms worsen or if my wife develops a fever. Neither has happened.
- The pediatrician has advised my wife to take antibiotics.
- We are torn between wanting to use as few harsh medications as possible and not wanting to take risks with our daughter's health.

We are concerned about the potential harm of antibiotics passing through breast milk. Additionally, antibiotics typically disrupt my wife's vaginal flora, leading to further treatment. We have the following questions:
- Does it make sense for our daughter if my wife takes antibiotics at this time?
- Can it significantly reduce the risk to our daughter?
- Is it likely that our daughter already has the bacterium and may not react to it?
- How effective is maternal immunity in preventing transmission?
- Will the desired effects of the antibiotic pass through breast milk to the child?
- What course of action would you recommend?

Thank you in advance.

Dr. med Ralf von Seckendorff

Hello,

I am happy to answer your questions:

None of your doctors are directly "wrong", but:

I am also on the side of your family doctor.

It can be assumed that your wife's infection still has a good chance of improving without antibiotics. If your daughter has not been infected so far, the likelihood is very high that the maternal immunity has been effective and your daughter has already fought off the bacterium. The antibiotic does pass into breast milk, but not in a way that would provide sufficient protection for your daughter, rather with the risk of possible side effects such as diarrhea and potential issues with gut flora for both of you. A significant reduction in the risk to your daughter is not guaranteed by taking the antibiotic.

Therefore, I would also recommend not taking the antibiotic unless your wife's condition worsens as advised by the family doctor. As a precaution, you should continue to use a face mask.

Best regards and all the best