Overuse of antibiotics for ear infections

Hard to argue with a crying child, but often doing nothing for in earache is just as beneficial as anti-biotics. Also, avoiding antibiotics avoids side effects, plus all the superbug -drug resistant strains – fears.

Critical Mass July 2008 with Chopper

When Latonia Best’s teenaged kids were little, doctors always prescribed antibiotics for their ear infections. But when her youngest son, 5-year-old Justin, was diagnosed with one recently, she heard something new: The pediatrician asked if she wanted to try waiting a few days to see if he would get better on his own.

Ms. Best, a mental-health aide who lives in LaGrange, N.C., opted to hold off on the drug, since her son wasn’t in pain and the doctor promised to phone in a prescription if needed. Two days later, he was fine. “I’d rather it heal itself,” says Ms. Best. She’s concerned that overuse of antibiotics will lead to powerful bacteria that resist the drugs, she says.

Ear infections are a rite of childhood, affecting more than three-quarters of kids before the age of 5. They’re also one of the most common reasons for visits to pediatricians, as parents seek relief for their crying, fussy young ones. But doctors and parents are deeply divided about how to treat them.

Current guidelines from the American Academy of Pediatrics and the American Academy of Family Physicians say that many patients, except the youngest and the sickest, can safely go without an antibiotic. Still, American doctors continue to prescribe the drugs very broadly for ear infections—to 84% of the kids they diagnose with them, according to a new analysis published in this month’s issue of the journal Pediatrics.

A growing number of studies have shown that most children with ear infections recover well without antibiotics, with little risk of more serious complications. Research in the journal BMJ in June even suggested that children who got antibiotics might be more likely to have recurrent infections.

[Click to continue reading When the Best Rx Is No Rx – WSJ.com]

Again, hard to argue with a crying child, and a worried parent, not to mention a healthcare system that rewards doctors for prescribing drugs.

Why do children get so many ear infections anyway? Is it all the milk they drink? Or why? Seems like an evolutionary flaw if such a large percentage of children consistently get infections in this orifice.

Still, some doctors say that when they explain the options to parents, many opt to wait on antibiotics.

Allan S. Lieberthal, a pediatrician at Kaiser Permanente in Los Angeles who is chairman of the current guidelines-writing effort, tells parents that the chance of a child getting better within a few days without an antibiotic is about 80%, while with the drug it is around 90%. If parents decide to hold off, he gives them a prescription that they can fill if the child has a high fever or worsening pain after 48 hours.

He also suggests they treat the pain with ibuprofen, following the current guidelines to use painkillers in children with earaches.

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