Too many children still given antibiotics for ear infections

Almost two-thirds of children with uncomplicated acute otitis media (AOM) -- a middle ear infection -- recover from pain and fever within 24 hours of diagnosis without treatment with antibiotics, and more than 80% recover within one to seven days.

Yet, according to an analysis conducted by the Southern California/RAND Evidence-based Practice Center (EPC) in the United States at least, medical doctors continue to prescribe antibiotics for the common childhood condition. The analysis was sponsored by the Agency for Healthcare Research and Quality (AHRQ).

AOM is one of the most common diagnoses in children. The EPC estimates that more than five million episodes of AOM occur each year at a cost of approximately $3 billion.

It is routine to use antibiotics for AOM in the U.S., whereas in other countries, such as the Netherlands, the standard practice is to use "watchful waiting" for one to two days after the onset of an ear infection in children over two years of age. Treatment is then administered only if the infection fails to improve during that period of time.

Although the EPC did not evaluate bacterial resistance to antibiotics, it has been reported that the rate of bacterial resistance in the Netherlands is about 1%, compared with a U.S. average of around 25%.

In the past, several other studies have indicated that antibiotics are not effective in treating AOM and that the overuse of antibiotics has lead to the rise of a strain a "superbacteria" which are resistant to today's antibiotics.

Additionally, some health care officials have suggested that the misuse of antibiotics in children is having a negative side effect on their natural immune systems.

SOURCE: "Antibiotic Treatment of Children with Acute Otitis Media," Agency for Healthcare Research and Quality (AHRQ), Aug. 10, 2000.