September 2003
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Many ear infections clear up without antibiotics
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Ellen Friedman, MD |
Most parents easily recognize the clues -- fever, pulling on the ear, and a general case of the “miseries.” It has to be an ear infection.
Most parents get their child to the doctor quickly because the symptoms will only get worse until the antibiotics kick in. Right?
Maybe not.
“Antibiotics are not necessarily the answer,” said Ellen Friedman, MD, professor of otorhinolaryngology at Baylor College of Medicine in Houston. “In many cases, the ear infection clears up on its own.”
While the traditional treatment has been antibiotics, Friedman said studies have shown that many ear infections improve without any treatment and with no complications.
It is often best to treat the symptoms – such as a pain reliever for fever – and give the infection a chance to heal on its own, she said.
Parents have had mixed responses. Often they insist on a prescription for antibiotics, thinking that is the only way to cure the infection because that is what has worked in the past. But, with the attention that has been given the growing problem of antibiotic resistance, some parents are now trying to limit their children’s exposure to antibiotics, Friedman said.
The American Academy of Pediatrics reported recently on a study that addressed parents’ insistence on antibiotics for ear infections. In the study, researchers gave parents of children with ear infections prescriptions for antibiotics but asked them to wait 48 hours before having them filled. Less than a third filled the prescriptions; the other two-thirds reported improvement without antibiotics.
Ear infections are a common problem in infants and young children, but in most cases, are minor. Usually, a child stops having ear infections as she gets older, though sometimes it’s necessary to provide relief with a surgical procedure to insert ear tubes to drain fluid.
Friedman recommends that parents schedule a follow-up visit for six to
eight weeks after the ear infection is diagnosed. This visit is important,
she said, in order to determine if all the fluid that remains after an
infection has disappeared.
“It’s the fluid that can cause many problems,” she said.
“The fluid that stays in the ear after an ear infection can affect
language, learning, concentration and behavior.”
And, with fluid, there may be no symptoms.
“You have to really look for signs that the hearing is not back to normal because there will likely be no clues like pain or fever,” Friedman said. “What you are more likely to notice is a lack of concentration, or even some behavior problems.”
She advises patients to schedule the follow-up appointment for an ear infection several weeks later so the pediatrician can verify that not only is the infection gone, but the fluid is gone, too.
| A Matter of Health | |
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Aspirin - for your health |