RENEE MONTAGNE, Host:
When it comes to children and ear infections, there's some new thinking. For years, medical researchers have tried to convince doctors not to use antibiotics to treat ear infections in children. Now two new studies turned that advice on its head. They say young children with ear infections should get antibiotics, and right away.
NPR's Richard Knox reports.
RICHARD KNOX: Nothing sends more kids to the doctor than middle ear infections, and nothing causes doctors to write more prescriptions for antibiotics.
DAVID SPIRO: The scope of this is huge. We prescribe approximately 13 million prescriptions every years for ear infections - 13 million.
KNOX: David Spiro of Oregon Health Sciences University says that's a real problem.
Many researchers say kids don't need antibiotics because their ear infections usually get better on their own, and antibiotic resistance is a really big problem. The more antibiotics doctors prescribe, the more germs change to avoid getting killed.
Spiro says a wait-and-see approach works. He did a study where parents got a prescription with instructions to hold off on the medicine for 48 hours.
SPIRO: We found that children in the wait-and-see group, parents did not fill the prescription approximately two-thirds of the time.
KNOX: And the earaches went away anyway.
Six years ago, the American Academy of Pediatrics made it official. They told doctors it's OK to adopt the wait-and-see approach. Even so, only about 20 percent of doctors have adopted it, mostly because parents and doctors want kids to get immediate relief from earache pain.
Now the highly regarded New England Journal of Medicine is publishing two studies that overturn wait and see. One is from the United States, the other from Finland. The studies looked at more than 600 children with middle ear infections.
Dr. Alejandro Hoberman of the University of Pittsburgh says half of the kids were given immediate antibiotic treatment and half got a placebo.
ALEJANDRO HOBERMAN: More young children with an ear infection recover more quickly when given the right antibiotic.
KNOX: That is, given the right antibiotic with no delay.
Hoberman says he did this study because he thinks things had gone too far with the wait-and-see approach.
HOBERMAN: What these studies are going to do is swing the pendulum to where it needs to be.
KNOX: Dr. Jerome Klein of Boston University says the new studies ought to settle the debate.
JEROME KLEIN: These studies are about as good as one could get in settling the question.
KNOX: But Klein says the new research may not persuade doctors who strongly support the wait-and-see approach. Some worry the result of the new studies will be more antibiotic resistance.
But Hoberman thinks resistance can be limited if doctors are careful to prescribe antibiotics only for children who truly have ear infections. That means getting a good look at the sick child's eardrum. If it's bulging outward, he says, that almost always means there's a bacterial infection in the middle ear. Hoberman says parents can help the doctor make a good diagnosis.
HOBERMAN: When they are told that your child may have or has an ear infection, it's OK to ask how bulging is the eardrum.
KNOX: He admits it's not easy for doctors to get a good look at the eardrum of a squirming infant or toddler who's got a painful earache. But with a couple of people to help hold the child down and then give plenty of hugs, it can be done.
Richard Knox, NPR News.
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