Antibiotics May Put Children at Risk of Repeated Ear Infections
July 1, 2009 by Karlynn Johnston
Filed under Super Natural
Nothing makes a parent feel worse than your child being sick, and ear infections are especially horrible. You never know what to do, how much pain they are actually in, to not get antibiotics and wait it out, or have some prescribed to your child. I have always read that giving antibiotics during an ear infection was useless, but this article actually states the the study shows that it does clear it up faster. The benefits don’t always outweigh the risks unfortunately, and I still am not sure where I stand on this one. Both of my kids (touch wood!) were under 2 when they had their first ones and there was no way I wasn’t getting them antibiotics, no matter if it didn’t help any faster.I understand where they are coming from with the painkillers, but I have had ear infections, and Tylenol barely touches the pain, not to mention not being able to eat, or sleep. But now if my children had one….I don’t think I would be getting anything prescribed. We try to shy away from antibiotics and I honestly can’t remember the last time we had some for any of our family members.
From The Guardian:
Giving children antibiotics for an ear infection could make them more vulnerable to similar infections in future, a new study has found. The researchers say that antibiotics should be used more carefully.
What do we know already?
Ear infections are one of the most common childhood illnesses, affecting almost all children at some point. Simple painkillers, like paracetamol, are the standard treatment.
Antibiotics help children get better more quickly, but there are downsides. These include potential side effects for the child, like diarrhoea, and also a wider risk that bacteria will evolve resistance to commonly used antibiotics, creating ’superbugs’ that can’t be easily treated.
At the moment, doctors are advised to offer antibiotics to children under 2 and to those with more severe infections. However, not much is known about the long-term consequences of giving antibiotics. A new study followed 168 children for 3 years after treatment to see what the after effects might be.
What does the new study say?
Children who took antibiotics for an ear infection had a higher risk of further infections over the next 3 years.
In the group of children who were originally treated with antibiotics, 63 in 100 went on to get another ear infection. Only 43 in 100 children got another infection if they’d been given an inactive placebo.
There are a couple of possible explanations for the results. Antibiotics could kill off some of the weaker bacteria causing the infection, leaving more space for tougher, antibiotic-resistant bacteria to grow. It’s also possible that killing bacteria with antibiotics means less work for a child’s immune system, leading to weaker protection from infections in future.
How reliable are the findings?
The researchers relied on a questionnaire, filled in by children’s parents, to find out how common repeated ear infections were. So, the accuracy of the results depends partly on how well parents could remember their children’s illnesses over the previous 3 years.
About 3 in 10 children given a placebo went on to have ear, nose, and throat surgery because of their original infection, compared with only 2 in 10 of the children given antibiotics. This could have affected the long-term results by changing the children’s risk of future ear infections.
Where does the study come from?
The study was done in the Netherlands. It was published in the BMJ (British Medical Journal), which is owned by the British Medical Association.
Funding came from the Netherlands Organisation for Scientific Research.
What does this mean for me?
Ear infections can be painful for children, but 8 in 10 cases clear up in a couple of days without treatment. Doctors usually recommend painkillers while the child gets better.
The research does show that children get better more quickly with antibiotics, but the benefits are small and might not outweigh the side effects. In one study, 81 percent of children got better in 1 to 2 weeks with no treatment, compared with 95 percent of children who took antibiotics.
Given the limited benefits of antibiotics, the chance of side effects like diarrhoea, and the wider problem of superbugs, the new study gives us even more reason to use antibiotics only when absolutely necessary.
As a compromise, doctors sometimes write a prescription and suggest parents wait a few days before using it. That way, if your child gets better, you needn’t bother with treatment. If your child gets worse, you can pick up the antibiotics without needing another doctor’s appointment.
What should I do now?
If older children get an ear infection, they’ll probably say their ear hurts. Younger children might rub or tug their ear, and cry more than usual. You might also notice a high temperature, a cough or cold, and fluid coming out of one or both of your child’s ears.
If you notice these signs, you could try treating your child with an over-the-counter painkiller, such as paracetamol. It’s important to follow the package instructions and give the correct dose of painkiller, depending on the child’s age. However, if you’re unsure what’s wrong, if painkillers don’t seem to be working, or if you’re worried for any reason, talk to a doctor.
From:
Bezakova N, Damoiseaux RAMJ, Hoes AW, et al. Recurrence up to 3.5 years after antibiotic treatment of acute otitis media in very young Dutch children: survey of trial participants. BMJ. 2009; 339: b2525.
© BMJ Publishing Group Limited (”BMJ Group”) 2009
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