We must give less antibiotics for children

Parents are doing a better job of not demanding antibiotics for every childhood illness, according to a study published in August in the Journal of the American Medical Association.

The study found that antibiotic prescriptions for upper respiratory infections (including ear infections) in children younger than 5 dropped 36 percent from 1995 to 2006, according to U.S. News and World Report.

In recent years, the U.S. Centers for Disease Control and Prevention and medical societies have put a lot of effort into trying to convince parents that antibiotics often don't help with children's colds and ear infections, particularly the very common otitis media with effusion (when fluid is trapped in the middle ear).

And in 2004, the American Academy of Pediatrics and the American Academy of Family Physicians adopted new guidelines for treating ear infections in children, urging doctors to try treating acute ear infections with two to three days of pain relief before prescribing amoxicillin.

But as recently as 2000, just 7 percent of parents surveyed were comfortable with the recommendation that pain relievers alone be used to treat the first few days of an ear infection.

Ear infections are one of the most common childhood ailments and doctors have long been concerned that antibiotics are overused for the condition because many kids would probably get better without them. The concern is that the overuse of antibiotics is leading to the emergence of antibiotic-resistant infections.

For the new study, Maroeska Rovers of the University Medical Center Utrecht in The Netherlands and colleagues surveyed parents of 168 Dutch children ages six months to two years who had participated in a study evaluating antibiotics for ear infections in 53 general medical practices.

Over the next three and a half years, 47 of the 75 children who had received the antibiotic amoxicillin had suffered at least one recurrence of an ear infection, compared to only 37 out of 86 children who had received a placebo. 

The researchers say the reason could be that the antibiotics somehow weaken the child's natural immune system response to the infection, making them more vulnerable to infections later on. Another explanation is that the antibiotics may change the makeup of microbes that exist in the child's respiratory system, making them more vulnerable to bugs that make them sick.