Subjects: Quality and safety
More than 75% of kids have at least one ear infection before age 5 and earaches are among the most common reasons why kids visit pediatricians. But doctors don’t agree how earaches should be treated.
Guidelines promulgated by the American Academy of Pediatrics and the American Academy of Family suggest that many kids will get better without antibiotics.
A recent study in the British Medical Journal even hinted that kids who receive antibiotics might be at greater risk for recurrent infections.
Nevertheless, US doctors prescribe them for more than 80% of the children they diagnose with earaches, according to a study in Pediatrics.
“I’m not looking at a study, I’m looking at a patient,” William Corporon a Kansas-based family practitioner told the Wall Street Journal. Corporan prescribes antibiotics when he diagnoses a bacterial ear infection.
Antibiotic-prescribing doctors believe the drugs help kids recover faster, though they admit the marginal gain is a day or less, at best. They also doubt the veracity of clinical trials on the subject, because they include kids that don’t have bacterial ear infections.
Meanwhile, many parents are not comfortable leaving an ear infection untreated, and others want the quickest possible recovery so their kids can get back to school or day care. In a survey of PCPs for example, 65% said parents’ requests for antibiotics was the most important factor leading to the prescription.
Allan Lieberthal, a pediatrician at Kaiser and chairman of an AAP group tasked to update guidelines on the subject says 80% of children will improve within a few days without antibiotics, while 90% will get better with the antibiotic. Lieberthal typically gives parents a prescription they can fill after 48 hours if the kid still has a fever or pain.