April 20, 2014
Risks may not outweigh benefits in antibiotic treatment for kids ear infections

A new study suggests that using antibiotics to treat ear infections in children may do more harm than good.

Doctors at Mattel Children's Hospital UCLA and the RAND Corporation reviewed data from 135 "scientifically rigorous clinical trials" on the practice of using antibiotic treatment for middle ear infections before before updating guidelines for the American Association of Pediatrics. After reviewing the studies, the doctors estimated that 80% of kids will improve within three days of symptom onset even if not given antibiotics.

The doctors also concluded that if the children were given antibiotics, 12% would see faster improvement, but 3-10% of the children would also experience a rash and 5-10% would develop the side effect of diarrhea. One of the study's authors commented on revising the standards for antibiotic treatment of ear infections in children:

"Not every ear infection needs to be treated with antibiotics," said Dr. Mark Vecchiotti, chief of pediatric otolaryngology at Floating Hospital for Children at Tufts Medical Center. He was not involved in the study. "It's not easy and we have to resist temptation in sick children to treat them with an antibiotic when we're not actually sure, knowing half of infections will resolve by themselves."
Doctors caution against using antibiotics indiscriminately for every infection, as overuse of the drugs can render them far less effective, and use of the medication does have some side effects. Doctors also found that "first-line" antibiotics such as amoxicillin work as well as newer, pricier formulations.

As for prevention, Dr. Vecchiotti says that the best way to avoid ear infections in kids is to not expose them to cigarette smoke, and not allow them to take a bottle to bed.