The American Academy of Pediatrics (AAP) has released new guidelines for the diagnosis and treatment of acute otitis media (AOM) which is ‘doctor speak’ for an ear infection.
An ear infection is one of the most common infections of early childhood and is also one of the most common reasons that antibiotics are prescribed. Guidelines from 2004 recommended that pediatricians use “watchful waiting” before prescribing antibiotics for an ear infection in some children.
The new guidelines for treating an ear infection with oral antibiotics are even more specific than those in 2004, and further clarify who are the best children to observe and those that should be treated right away. This will reduce the number of unnecessary antibiotics that are prescribed, which in turn may help prevent antibiotic resistant bacteria.
Many parents worry that their child may develop an ear infection after having a cold, but for a child between 6 months and 12 years of age, a mild ear infection found during a visit to their pediatrician may now be observed for 72 hours.
According to the new AAP guidelines, children need to receive immediate antibiotics if they have a severe ear infection (with a fever of 102.2 degrees or higher or significant pain), have a ruptured ear drum with drainage or an ear infection in both ears in a 2 year old or under. This will really change current treatment and the number of antibiotics prescribed.
As both pediatricians and parents know, there are all sorts of things that cause ear pain: an erupting new molar, a cold, or a sore throat can all result in ear pain and a “cranky” child. But if the eardrum is not bulging the best treatment is pain control. This can be accomplished with acetaminophen or ibuprofen and watchful waiting to see if a child’s symptoms worsen or if the pain and symptoms resolve. In studies, 2 out of 3 children get better without an antibiotic.
More and more parents are responsive to using fewer antibiotics for their children and these recommendations reinforce that antibiotics don’t treat viral infections or pain. Save the antibiotics for use when there is evidence of a bacterial infection.
The next time your child has a cold and complains of an earache, try this approach and you may see that the ear pain resolves in 24-48 hours and you have one less trip to the pediatrician!