Antibiotics are bad solution for ear infections!

In the last few years there has been a sharp increase in doctors’ awareness that antibiotics are not the only solution and should not be subscribed carelessly.

Children treated on a regular basis with amoxicillin for Middle Ear Infections (Acute Otitis Media) are more likely to experience recurrent infections than those not treated constantly with antibiotics.

A research done in the University Medical Center Utrecht in the Netherlands reviewed 168 children, aged 6 months to 2 years, who presented symptoms of otitis media. The study divided the children to 2 groups – one receives 40 mg/day of Amoxicillin and the other got a placebo.

Of the 75 children in the amoxicillin group, 47 (63 percent) experienced a recurrence of infection, compared to 37 (43 percent) of the 86 children treated with placebo, the investigators found. Referral rates to secondary care were the same for both groups, at 30 percent; however, only 21 percent of the amoxicillin group was referred for ear, nose and throat surgery, compared to 30 percent in the placebo group.

As antibiotics are still widely prescribed in young children with acute otitis media, it is important to listen to the new guidelines issued recenty by the AAP (American Academy of Pediatrics) regarding children’s ear infections. This study is another argument for judicious use of antibiotics in children with acute otitis media.

Giving children antibiotics for an ear infection could make them more vulnerable to similar infections in future. When the human body receives constant antibiotics to fight infections, it does not strengthen the immune system as well as fighting an infection by itself every now and then.

What do we know about the relation between recurrent ear infections and Antibiotics?

Ear infections are one of the most common childhood illnesses, affecting most children. Standard treatments for ear infections include antibiotics, Simple painkillers (like Paracetamol) and ear drops. In harder cases, an ENT may be required to examine the child and conclude if Ear Tube surgery is needed.

While pain killers are effective and easy to come by, they should not be given easily. With antibiotics, it is even more important to be precautious. Antibiotics help children get better more quickly, but there are downsides. Potential side effects for the child include diarrhea, dizziness, weakness or reduced energy and loss of appetite. Even more importantly, there is a wider risk that the body (and sometimes even the bacteria) will become resistant to commonly used antibiotics, making the antibiotics less effective in the long run. If such resistance occurs, a larger dosage may be prescribed or a change of antibiotics may be required.

If you are not sure if you should use antibiotics or give it to your child – check out the guidelines from the AAP and understand better.

What does the new study say?

Children who took antibiotics for an ear infection had a higher risk of additional infections over the 3 years following a repeated use of antibiotics. In the group of children who were originally treated with antibiotics, 63 out of 100 got another ear infection. Only 43 in 100 children out of the Placebo group got another infection.

The study also suggests possible explanations for the results:
(A) Antibiotics are usually able to get rid of the weaker bacteria, leaving stronger, tougher and more resistant bacteria which will grow again and cause another infection and more pain.
(B) When the body is assisted in fighting the infection with the aid of antibiotics, the immune system does work as hard as it would without it. Due to the decreased effort, the immune system is not as developed as it would without the antibiotics’ help.

One important finding is that 3 out of 10 children given a placebo needed an ENT’s attention and surgical procedures due to the original infection, and only 2 in 10 of the children given antibiotics needed surgery. Although the research inconclusive about this result, it seems that antibiotics prevented need in surgery in the long term.

Where do these findings come from?

The researchers asked parents to fill out a questionnaire which aimed to reveal how common the repeated ear infections were. The accuracy depends on the parents’ memory of their child’s ear infections over the 3 years preceding the study.

What does this mean for me, my child and his ear infection?

Ear infections can be painful for children, especially when it happens often. However, 8 in 10 cases clear up in 48-72 hours without treatment. “Wait & watch” is becoming an increasingly popular strategy, and doctors usually recommend painkillers during the waiting period.

According to the research, Children get better faster when prescribed antibiotics but the benefits are small and the side effects may make it less beneficial. Another study revealed that 81 percent of children with Otitis Media got better in 7-10 days without antibiotics, compared to 95 percent of the children who got antibiotics. Chances are your child can get better from the ear infection without antibiotics almost as good as he would do with the antibiotics.

Sometimes, doctors prescribe medication and suggest the parents to wait for a few days before using them. This is a compromise which allows the parent to follow up on his child’s status and decide if the child needs the antibiotics after all. If your child feels better, you can put the prescription aside. If your child feels the same or worse, you can get the antibiotics at the closest pharmacy and without another appointment.

What should I do now?

If your child is prone to ear infections, you should know the symptoms of ear infections. These may include tugging of the ear, crying, mild hearing loss or loss of balance. If you suspect an ear infection, go to the pediatrician. He can check your child and see if the ear drum is swollen and infected.

We hope you found this article useful. Feel well soon!

 
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