Waiting before taking antibiotics for ear infections

Parents who've ever suspected their young  kids had an ear infection might have been inclined to call the doctor, schedule a visit and expect an antibiotics or ear tube surgery.

Patients suffering from minor illnesses such as coughs, colds and ear infections can no longer hope for reprieve through antibiotics.

Until eight years ago,  each ear infection was treated with antibiotics The thought was, you would reduce the symptoms quicker,Then it became clear that many children who weren't treated with antibiotics actually did well without the initial treatment.

The National Institute for Health and Clinical Excellence (NICE), the NHS drugs rationing body, has issued the new guidance in which doctors are prohibited from prescribing antibiotics for minor illnesses such as an ear infection, sore throat, tonsillitis, a cold, sinus infection, cough or bronchitis.

Ear infections are the most common illness among infants and young children, according to the U.S. National Institutes of Health, with an estimated three of every four kids having an ear infection before age 4. Usually infection occurs in the middle ear and is called otitis media. It's called otitis media with effusion when fluid and mucus build up in the tubes of the middle ear.

Ear infections often clear up on their own. But another pediatric otolaryngologist, Dr. Richard Rosenfeld, stressed that "observation is different than no treatment." Rosenfeld is chairman of otolaryngology at Long Island College Hospital and the State University of New York Downstate Medical Center and a consultant for the American Academy of Pediatrics on the ear infection guidelines.

When recommending observation before medication, he said, doctors might send parents home with a "safety net" prescription, one to have on hand in case the situation worsens. Parents should ask the doctor for specifics on the timeline for observation, which typically ranges from one to three days.

And while watching and waiting, the focus would be on pain relief. parents may also try the eardoc for opening the Eustachian tube and reliving the pressure on the ear drum.

But observation isn't advised for all kids, even if they're healthy and 2 years or older. For instance, a child with a fever of 102 or more would typically be treated.

The antibiotics guidelines are aimed to address concerns about resistance to antibiotics that can develop from overuse. Also, a study reported in the British journal  found that ear infections come back more often in kids who've been treated with antibiotics. In the three years after being treated for an ear infection, 63 percent of the kids who were given the antibiotic amoxicillin had recurrent ear infections, compared with 43 percent of those not treated with an antibiotic. Parents and doctoers are becoming used to the idea that antibiotics are not the first choice.Eardoc, pain control and pain management might need to take center stage, at least initially.

Anesthetic ear drops, which usually require a prescription, can help but don't produce prolonged relief. And the practice of putting warm compresses on the outside of the ear  can't hurt, he said, but there's no real proof that it works, either.

More information : businessweek