The Kid's Doctor: New guidelines issued on ear infections
Sunday, March 24, 2013
The changes will reduce use of antibiotics.
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By Sue Hubbard, M.D.
   The American Academy of Pediatrics (AAP) just 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 maladies of early childhood and also one of the most common reasons 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 ear infections with oral antibiotics are even more specific than those issued in 2004, and further clarify which 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 old, a mild ear infection found during a visit to their pediatrician may now be observed for 72 hours.
  According to the new 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 child age 2 or under. This will really change current treatment and the number of antibiotics prescribed.
  As both pediatricians and parents know, all sorts of things that cause ear pain, from an erupting new molar to a cold or sore throat. 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 resolves. 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 new recommendations reinforce that antibiotics are not appropriate for viral infections or pain. Save the antibiotics for use when there's 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 disappear in 24-48 hours without a trip to the pediatrician!
Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show. Submit questions at
This was printed in the March 24, 2013 - April 6, 2013 Edition

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