Published: Fri, December 23, 2016
Medical | By Ismael Lynch

Infant ear infections need full antibiotic course

Infant ear infections need full antibiotic course

A shorter course of antibiotics resulted in less-favorable outcomes compared with the standard 10-day regimen for the treatment of acute otitis media in young children, new research from the University of Pittsburgh shows. The researchers thought cutting the length of antibiotic treatment might still be effective against ear infections and help prevent the development of antibiotic-resistant bacteria in the babies.

The study included 520 children between 6 and 23 months old who were diagnosed with an acute middle ear infection, a very common childhood illness.

Importantly, the study also shows for the first time that nearly one in two children in whom residual fluid was observed in the middle ear after treatment had a recurring infection, a significantly higher percentage when compared to children without any residual fluid in the middle ear. Parents, researchers and clinicians didn't know what treatment a child was getting. But antibiotics can cause an upset stomach and rashes and there's always the concern for antibiotic resistance, so doctors wanted to see if kids would do just as well with 5 days of treatment instead of 10.

Katherine Fleming-Dutra, MD, of the Center for Disease Control and Prevention says that while shorter antibiotic regimens have been found to work just as well as longer courses in some conditions, such as urinary tract infections and pneumonia, "every infection is different".

In addition, the investigators observed no significant differences between the two groups in the rates of adverse events (such as diarrhea), recurrence of otitis media, or antimicrobial resistance.

Jocelyn Maynes and her son Bronson NBC News
Jocelyn Maynes and her son Bronson NBC News

The results were a surprise, says Dr. Hoberman is chief of the general academic pediatrics division at Children's Hospital of Pittsburgh of UPMC. Antibiotics against common infections should be used for short term.

Limitation of the study is that results can't apply generally to older children.

Traditional teaching is that that taking an antibiotic for a longer period of time may pose an increased risk for developing antibiotic resistance.

Hoberman and his colleagues write that their study was meant to address some methodological gaps in previous studies, which have shown either no difference in outcome between the two treatment options or small differences that favored 10-day treatment. The quality of the design of the study was noted by Margaret A. Kenna, otolaryngologist at Boston Children's Hospital, in an editorial accompanying the journal article. It can kill off the "good" bacteria in a child's body and frequent dosing of antibiotics in early childhood is linked with obesity. "The whole notion of really figuring out the optimal duration of therapy is one we've been advocating heavily for". Antibiotics are commonly prescribed to treat an ear infection, but is a short course of antibiotics the best way to treat an ear infection in a child?

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