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Home › Articles › Toddler Health › Avoiding Antibiotics

Avoiding Antibiotics

New Guidelines for Ear Infections

By Kelly Burgess

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The pediatrician's office that Katie Young takes her three children to has five doctors. She dreads those mornings when one of her children wakes up feverish and fussy and she calls in only to discover that the only pediatrician available is Dr. X.

"This doctor won't give antibiotics even if I can tell that my kid needs them," says Young, of Austin, Texas. "After three kids, I think I know a little bit about what's up with my own kids' health. I'm not the only parent that feels that way, either. We don't really understand why she has to drag everything out; it just takes longer for the kids to get better."

It's parents like Young that are going to be the tough sell now that the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) have released their long-awaited new guidelines for ear infections.

Wait and See
These guidelines have been in the works for some time, and they are controversial simply because they suggest using pain relief rather than antibiotics in some cases – even if there is evidence of infection. As the chart below shows, these guidelines will be based upon both age and symptoms.

This is not a new idea. The medical community has been becoming increasingly worried about American's over-reliance on antibiotics for a number of years. The impetus behind this movement is that the number of antibiotic-resistant illnesses is growing. And it's ear infections in children that account for a huge number of the antibiotics currently prescribed.

Dr. Richard Rosenfeld is a New York-based pediatrician and co-chair of the Otitis Media With Effusion subcommittee for the AAP, as well as a consultant for the guidelines on acute otitis media. "The main reason we're doing this is because there are terrible problems with antibiotic resistant diseases," says Dr. Rosenfeld. "People die more and more from infections that are resistant to antibiotics and this happens from a liberal use of antibiotics. They create hardier bacteria that are just waiting to spring into action."

Dr. Rosenfeld says that the New York State Department of Health published a set of guidelines back in 2002 that advocates observation first, antibiotic treatment later. Called the "Observation Option Toolkit for Otitis Media," it is a forerunner of the new national guidelines.

A Difficult Diagnosis

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