Antibiotics and Ear Infections

The old medical approach has been to routinely give antibiotics for acute ear infections. Ear infections are the top reason that antibiotics are given to children and the top reason that children get general anesthesia for surgery. It’s quick, easy and convenient for doctors to write an antibiotic prescription for ear infections, and parents want quick relief for their kids.

Simply giving antibiotics for ear infections doesn’t take into account where ear infections and ear pain come from. Nor does it take into account the consequences of these antibiotics — for us or the environment.

When antibiotics are given, kids are a bit more likely to get another ear infection sooner. And each time a child takes a course of antibiotics, future infections become harder to treat.

A typical healthy child carries a pound or two of rapidly evolving microscopic bacteria in his or her body. Antibiotics cause the selective breeding of the more resistant strains, which leads to the use of newer, harsher, more expensive antibiotics, with more side effects, creating a negative cycle. And some of the antibiotics given will end up in our water supply, as we’ve heard in the news recently, perhaps affecting wildlife as well as us.

Parents often want to start antibiotics for the ear infection because we’ve mistakenly taught them to think this will reduce their child’s pain. In the first 24 hours, though, there is no difference in pain level whether or not the child gets antibiotics.

We’ve also taught them to think that these medicines will help their child to recover. However, of about 10 million annual antibiotic prescriptions for ear infections, somewhere between 8.5 million and 9.5 million prescriptions didn’t actually help the children, according to the American Academy of Pediatrics.

Put another way, we have to treat between seven and 20 children with antibiotics for ear infections before one child benefits from the medicine. About 80 percent of ear infections will clear up easily without antibiotics.

In 5 to 14 percent of children, the antibiotics will take one day off the length of the ear infection. But by comparison, up to 15 percent of children who take antibiotics will develop vomiting or diarrhea, and up to 5 percent will have allergic reactions, some of which may be quite serious.

I believe antibiotics to be among the greatest inventions of the 20th century, but most children would be better off without the routine use of them.

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