Posted On: March 15, 2013 by Patrick A. Malone

Rethinking the Use of Antibiotics for Ear Infections

It’s a simple equation: child + ear infection = antibiotic treatment. Except that the formula is being reworked.

In an effort to limit the unnecessary use of antibiotics, the American Academy of Pediatrics has issued new guidelines for diagnosing and treating children’s ear infections.

As reported by NPR, ear infections are among the most commons reasons parents bring their children to the pediatrician, and the primary reason kids get antibiotics. When your kid is screaming all night, and tugging at his ear, you will do anything to make the hurt go away.

But about 7 in 10 kids will improve within a couple of days without drug intervention; about 8 in 10 get better within a week to 10 days, said one of the doctors involved in writing the new guidelines.

In addition to helping bacteria develop resistance to drugs, taking antibiotics when they’re not necessary can cause stomach problems and allergic reactions.

According to the new guidelines, the first thing parents should do if their child is having ear discomfort is to ensure it’s really an infection instead of another problem that also causes pain. Infections can be diagnosed only by having a doctor view the eardrum to see if it’s bulging. Infection causes that structure to push outward, as if it wants to pop.

Even then, however, that doesn’t mean an antibiotic is in order. If the immediate need is to relieve pain, other drugs can do that without the side effects or bacteria-boosting consequences.

If a child clearly has a severe infection—intense pain, high fever, bulging eardrum—antibiotics are indicated. Also, any child 6 months to 2 years old who has infection in both ears should take antibiotics, as should a kid whose eardrum has ruptured.

Doctors have options they didn’t used to have, and they should consider whether it’s best to offer parents the safety net of antibiotics, or to adopt a wait-and-see approach, and treat only the pain for a day or two. If they opt for “watchful waiting,” a prescription for antibiotics can still be given, and filled only if the child isn’t better in a couple of days.

Breast-feeding seems to help a child resist ear infections in the first place, as does keeping the kids away from cigarette smoke.

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