Almost two out of three antibiotic prescriptions written for children are for otitis media, or middle ear infections. Researchers from the University of Texas Medical Branch in Galveston and the University of Colorado in Denver examined whether parents would be satisfied with a wait-and-see approach when it came to treating some ear infections.
The parents of 223 children between 6 months and 12 years seen for ear infections provided information about the severity of their child's symptoms, such as ear pain, fever, irritability, and poor appetite. They also noted whether the child had missed school or day care due to the ear infection. After the children underwent physical exams and had been diagnosed with otitis media, parents received information about the definition of an ear infection, the causes of ear infections, what characterizes a severe and nonsevere ear infection, and information about antibiotic resistance. Then the children were divided into two groups. Half of the children received immediate antibiotics to treat the ear infection as well as pain relievers and over-the-counter medicines to reduce symptoms associated with ear infections. The other children didn't get antibiotics, but did receive the pain relievers and over-the-counter medications. The study researchers followed the children in both groups for a month after diagnosis to ensure that the infection cleared up. If children in the wait-and-see group had infections that worsened, they then received antibiotics. All of the children had tests for bacteria throughout the month after diagnosis, and parents completed surveys about their experience with their child's treatment.
Two thirds of the children assigned to the wait-and-see group didn't need antibiotics during the study. Parents in both the wait-and-see and the antibiotics treatment groups had similar levels of satisfaction with their child's treatment midway through the treatment and at the end of the month-long study. Children who took antibiotics did have faster relief of symptoms and used less pain medication, but they were also more likely to be found to be carrying bacteria in their noses that was resistant to multiple types of antibiotics. Antibiotic treatment was also several times more expensive than wait-and-see treatment.
What This Means to You: The researchers of this study suggest that educating parents about antibiotic resistance, the causes of ear infections, and the varying severity of ear infections can help them feel better about taking a wait-and-see approach to treating otitis media. Middle ear infections can be uncomfortable for kids, but avoiding unnecessary antibiotic treatment can spare a child the symptoms associated with drug allergies and other side effects. And preventing overuse of antibiotics can also help limit the emergence and spread of antibiotic-resistant bacteria.
If you have questions about antibiotic treatment of ear infections, talk to your child's doctor.
Source: David P. McCormick, MD; Tasnee Chonmaitree, MD; Carmen Pittman, BA; Kokab Saeed, MD; Norman R. Friedman, MD; Tatsuo Uchida, MS; Constance D. Baldwin, PhD; Pediatrics, June 2005
Reviewed by: Steven Dowshen, MD
Date reviewed: July 2005