Cutting Antibiotics for Ear Infections

Sept. 12, 2006 -- Most children with ear infections do not need antibiotics, but they get them anyway. Now, a new study suggests parents are often willing to delay treatment if they know their kids can get the drugs if they need them.

Giving parents the option of delaying treatment meant far fewer kids ended up taking antibiotics -- with no significant increase in complications, researchers reported in the Sept. 13 issue of JAMA, The Journal of the American Medical Association.

In the study, almost two-thirds of the antibiotic prescriptions written to parents urged to delay treatment never got filled.

Meanwhile, roughly nine of 10 children whose parents were not given the special instruction to "wait-and-see" ended up taking antibiotics.

15 Million Ear Infection Prescriptions

Ear infections are the most common reason for antibiotic use among U.S. children, with 15 million prescriptions written annually.

Antibiotic resistance is a growing worldwide public health concern that has been spurred by the widespread overuse of the drugs.

"In this country, 96% to 98% of physicians treat ear infections immediately with antibiotics, even though most cases will resolve on their own without treatment," David M. Spiro, MD, MPH, tells WebMD.

Spiro and colleagues from Yale and Vanderbilt University conducted their study to determine if parents would accept a "wait-and-see prescription" approach to antibiotic treatment when their children had ear infections, and whether the approach would reduce antibiotic use.

The study included 283 children between the ages of 6 months and 12 years with ear infections treated at an urban hospital emergency department.

Children were not included in the study if they had another infection such as pneumoniapneumonia, were severely ill from the ear infection, were hospitalized, had ear tubes or a ruptured ear drum, or had received antibiotics within the prior week.

Roughly half the studied children received prescriptions for antibiotics with no special instructions.

The other half also received prescriptions, but parents were asked not to fill them unless the child was either "not better, or worse" after 48 hours.

All the children were given free bottles of ear drops for pain and liquid ibuprofen, which was a very important part of treatment, Spiro says.