The 72-hour prescription chase: The prescription for panic

Medication Safety Alert: When Parental Fear Becomes a Prescription—and Why We Must Stop Overmedicating Our Children

By Dr. Fiaz Maqbool Fazili

Seema, a teacher, faced every parent’s nightmare when her two-year-old suddenly developed a 102°F fever, relentless cough, listlessness, poor appetite and sleeplessness. Like any worried mother, she panicked—not from carelessness, but because seeing a small child suffer makes calm reasoning difficult. She took the child to a paediatrician, who diagnosed a likely viral infection and advised paracetamol, fluids, observation and vigilance for danger signs—no antibiotics. The doctor explained that such illnesses often take days to settle. Seema went home reassured, but not for long.

The 72-hour prescription chase

That night, the fever persisted and the child grew restless. By morning, Seema’s rational confidence gave way to every parent’s fear: What if something was being missed? She sought a second opinion, and the doctor prescribed an antibiotic “just to be safe.” Relieved that something was being done, she went home.

After 48 hours, the cough remained and the fever still spiked. Fear returned, prompting a third consultation. The new doctor reviewed the earlier prescriptions, changed the antibiotic and added medicines, which Seema followed carefully.

By 72 hours, the fever subsided, sleep improved and the cough eased—so the third doctor was declared the hero.

But did the third doctor cure the child—or did the illness simply improve on its own?

Seema’s story shows how easily we confuse timing with treatment. When a child improves after a new prescription, we credit the latest medicine, even though many viral illnesses resolve because the immune system has done its work—not because an antibiotic was added late.

The lesson is not to avoid antibiotics or ignore persistent fever. It is that a prescription does not always mean better care, and waiting is not neglect. Sometimes the hardest prescription for a doctor is none at all—and the hardest advice for a frightened parent is to watch, care and wait.

How many of us fall into the 72-hour trap?

Viral illnesses take time: fever may last several days, and coughs longer. Yet we often see persistence as treatment failure. When one doctor advises “wait and watch” and another prescribes an antibiotic, the second may seem more decisive. If the child improves, the prescription gets the credit—not the illness’s natural course.

This creates a dangerous incentive: the doctor who prescribes more appears to offer better care.

Antibiotics are essential for bacterial infections, but harmful when used without a reasonable indication.

Antibiotics treat bacteria, not viruses. Most childhood coughs, colds and many acute diarrhoeal illnesses are viral, so antibiotics do not speed recovery; they only expose the child to avoidable risks without benefit.

When one prescription discredits another

Another overlooked problem is discrediting the previous doctor. Comments like “This medicine is harming your child” may be justified if prior treatment was dangerous, but when used routinely they erode trust and suggest that only the new doctor has the right answer.

This encourages “poly-doctoring”—moving from clinic to clinic until a family gets the desired prescription. Each visit may add another antibiotic or cough medicine, turning the child into the site of parental anxiety and professional disagreement.

The better approach is simple: validate sound prior care before changing it.

A doctor might say, “The previous treatment was reasonable. This still looks viral. Let’s continue supportive care and watch for warning signs.”

It may sell fewer medicines, but it builds something far more valuable: trust.

The hidden cost of “just in case” antibiotics

The hidden cost of “just in case” antibiotics is real. They are not harmless insurance: every unnecessary course fuels antimicrobial resistance, making infections harder to treat.

Children may also suffer diarrhoea, allergic reactions and gut microbiome disruption, so needless exposure creates avoidable harm.

The problem goes beyond antibiotics. Multiple medicines for simple symptoms—cough syrups, antihistamines and other preparations—may look comprehensive but add little value.

More medicines do not automatically mean better medicine.

Parents are anxious for a reason

Parents are anxious for a reason; it would be unfair to put all the blame on parents. A feverish, miserable child is frightening. Parents are not sitting in a clinic with a medical textbook in their hands. They are trying to decide whether their child’s illness is ordinary or dangerous.

In that situation, “do something” feels safer than “wait.”

The answer is not to shame parents for seeking medicines, but to explain what waiting means. When a doctor says, “no antibiotic,” the parent still needs a plan: hydration, comfort, expected symptoms, recovery time and warning signs that require urgent reassessment.

Clear reassurance with safety-netting is not inaction—it is treatment.

Medical practice in J&K needs a culture of restraint

Medical practice in Jand k needs a culture of restraint. This is where health policy matters. A stronger antibiotic-stewardship(policy) efforts across public and private paediatric care. Prescribing should be guided by clinical evidence rather than by the fear of losing a patient to another practitioner.

Medical institutions and professional bodies should promote consistent communication among doctors. Prescriptions should change only when the child’s condition warrants it—not to prove a new doctor knows better.

Parents also need public education on common childhood infections, especially that no improvement after 24 or 48 hours does not automatically mean an antibiotic is needed.

At the same time, “wait and watch” must never become an excuse for ignoring serious illness. Infants, children with breathing difficulty, severe dehydration, altered consciousness, persistent deterioration or other danger signs need prompt medical evaluation.

Stewardship means using the right medicine at the right time—not withholding necessary treatment.

The courage to do less

Medicine often celebrates quick action and decisive prescriptions. But good care sometimes means saying: this is likely viral, antibiotics will not help, and your child needs fluids, comfort, observation and time.

It also means resisting pressure for stronger medicines, avoiding criticism of earlier doctors, and recognizing that sometimes the doctor who prescribes the least is doing the most.

The child in our 72-hour story did not necessarily recover because the third doctor found a magic combination; the recovery may simply have coincided with the illness running its natural course.

That distinction matters—not just for one family, but for society.

If we keep equating prescriptions with competence, we will keep producing unnecessary medicines, avoidable side effects and increasingly resistant bacteria.

The wake-up call is simple: good paediatric care should not be measured by how many medicines leave the clinic with the child.

Sometimes the best prescription is a careful examination, a clear explanation, a safety net—and the discipline to wait.

The goal is not to give children less care, but the right care, and nothing they do not need.

Author is a lifelong observer of Kashmir’s social change, civic life and intergenerational challenges.