Doctors Urged to Delay Kids’ Earache Drugs

The above headline comes from the June 6, 2003 edition of the Atlanta Journal Constitution (AJC). The article starts off by saying, “Doctors are being advised to withhold antibiotics for two to three days for many children with earaches in an effort to curb the growing problem of antibiotic resistance.” The Academy of Pediatrics is planning on initiating a campaign called, “watchful waiting” this fall in response to the growing problem.

According to the AJC article, about 10 million prescriptions for antibiotics are written every year for kids with ear infections. This number represents nearly half of all antibiotics used among preschoolers. However the article notes that 81 percent of the ear problems go away without medication, according to the U.S. Agency for Healthcare Research and Quality, a division of the Department of Health and Human Services. (see article here)

Dr. Richard Rosenfeld, a pediatric ear, nose and throat specialist at Long Island College Hospital in Brooklyn, says, “You’re not getting a lot of bang for your antibiotic buck with this disease.” Dr. Rosenfeld spoke at a centres for Disease Control and Prevention conference in Atlanta and is helping the Academy of Pediatrics finalize its guidelines. Those new guidelines tell pediatricians and family physicians to hold off on antibiotics for children older than 6 months if doctors aren’t sure of a true ear infection. The new guidelines also suggest that antibiotics should be given for just five days, instead of seven to 10 days, for children older than 2.

The AJC article also noted that many earaches are viral and don’t involve fluid in the middle ear, a sign of infection. Nearly 20 percent of true ear infections are caused by viruses for which antibiotics don’t work. Dr. Gerald Reisman, with Dunwoody Pediatrics in Atlanta noted, “It may take a while for parents to accept the new approach away from routinely using antibiotics to treat their children. Parents often have the expectation that their child is sick and needs an antibiotic to get well, and some really put the pressure on,” he said. “But now we can say, ‘It’s not just me. It’s the CDC and the Academy of Pediatrics.’ “

Dr. Rich Bessler, a CDC infectious disease specialist, noted that other countries in Europe have successfully implemented campaigns to delay antibiotic use for earaches. Dr. Rosenfeld closed the article by suggesting that parents need to realize that an earache, even though sometimes painful, is almost always harmless.