Q: My child has had a fever for 4 days and started antibiotics, but it's still not going down. Should we go back to the hospital?
- Myeongchan Kim, MD
- 6 hours ago
- 3 min read
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
My child's fever started four days ago in the evening. It keeps rising to the high 38°C (101-102°F) range, though it drops temporarily when I give fever reducers. Two days ago, we were prescribed antibiotics. The chest X-ray was normal, and the doctor mentioned a slightly swollen throat. The cough wasn't severe initially, but a wet cough with phlegm started today. Tomorrow will be the fifth day of the fever. Should I take my child back to the clinic immediately? I am especially worried because my child suffered terribly from antibiotic-induced enteritis (intestinal inflammation) last year.
Answer:
It is completely understandable that you are worried, especially since the fever has lasted for several days and hasn't completely resolved after starting antibiotics.
Here is a breakdown of your child's current situation and what you should do next:
When Do Antibiotics Start Working?
Typically, it takes about 48 to 72 hours after starting antibiotics for a fever to begin dropping. Since your child started the medication roughly 24 to 48 hours ago, it is generally safe to monitor their condition for another day to allow the medicine time to work, provided there are no severe symptoms.
Red Flag Signs That Require Immediate Medical Attention:
Please take your child to the doctor or emergency room today if you notice any of the following:
Rapid breathing or chest retractions (the skin pulling in under the ribs when breathing).
Refusing to drink fluids or going more than 8 hours without urinating (signs of dehydration).
Extreme lethargy, difficulty waking up, or an inability to make eye contact.
A fever of 40°C (104°F) or higher, or a fever that does not respond to fever reducers at all.
Severe throat swelling or pain that makes swallowing difficult.
Home Care Tips for Now:
Fever Reducers: Use them only when your child is uncomfortable. You can use acetaminophen (every 4-6 hours) or ibuprofen (every 6-8 hours), strictly following the dosage for their weight.
Hydration: Offer small, frequent sips of water, clear broth, or popsicles.
Phlegm Management: Use normal saline nasal drops or sprays, and keep your indoor humidity between 40-60% to help loosen the mucus.
Antibiotics: Continue giving the antibiotics exactly as prescribed. Do not stop the medication early without a doctor's approval.
When to Revisit the Doctor:
If the fever continues past the 72-hour mark of taking the antibiotics (by tomorrow evening), or if your child's symptoms worsen, you should revisit your pediatrician. The doctor will need to re-evaluate to see if a different antibiotic is necessary or if additional tests (such as blood or urine tests) are required.
Preventing Antibiotic-Induced Enteritis:
Given your child's history of gastrointestinal issues with antibiotics, you may want to consider giving them pediatric probiotics alongside the medication, but please consult your doctor about the best timing and type. Keep a close eye on their bowel movements, and if diarrhea starts, contact your pediatrician for immediate guidance.
For today, keep your child comfortable, ensure they stay hydrated, and watch closely for any of the warning signs mentioned above.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
