Antibiotics fight ear infection faster - study

by Aimee Keenan-Greene 

What's the best way to treat a child's ear infection?

Recommendations vary when it comes to antimicrobial treatment. Some studies suggest only watchful waiting for children younger than 2 years of age with acute otitis media.

According to the American Academy of Pediatrics, ear infections are common in young children and result in millions of office visits and antibiotic prescriptions annually. Acute otitis media is the most common bacterial illness in children for which antibacterial agents are prescribed in the US.

About 90 percent of children have an ear infection some time before school age, most often between ages 6 months and 4 years. 

A new study in the journal Pediatrics says children ages 6 to 23 months with acute otitis media treated with amoxicillin–clavulanate for 10 days saw their symptoms reduced sooner.

Close to 300 children took part in the study. Among the children who received amoxicillin–clavulanate, 35 percent had initial resolution of symptoms by day 2, 61 percent by day 4, and 80 percent by day 7.

Among children who received placebo, 28 percent had initial resolution of symptoms by day 2, 54 percent by day 4, and 74 percent by day 7.

The rate of clinical failure, defined as the persistence of signs of acute infection on otoscopic examination, was also lower among the children treated with amoxicillin–clavulanate than among those who received placebo: 4 percent versus 23 percent at or before the visit on day 4 or 5  and 16 percent versus 51 percent at or before the visit on day 10 to 12.

Diarrhea and diaper-area dermatitis were more common among children who received amoxicillin–clavulanate in this recent study.

The study was funded by the National Institute of Allergy and Infectious Diseases.

Seven years ago the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) jointly released the first national clinical practice guideline on appropriate diagnosis and treatment for AOM. The guideline outlines steps for more accurate diagnosis, encouraging pain relief, reducing antibiotic-related adverse effects, and targeting antibiotics for children likely to receive the most benefit.