Most child ear aches do not need antibiotics

Sep 13 2006

According to the latest research the most common reason why doctors prescribe antibiotics for children is ear ache, and often most ear aches would clear up without them.

The debate on the over prescribing of antibiotics has been going on for years but has had more resonance of late with the emergence of so-called super-bugs which are often resistant to most of the widely used antibiotics.

It seems that almost 15 million prescriptions for antibiotics are doled out each year to treat ear aches when all that is needed is eardrops and a painkiller.

Doctors are now advocating the WASP procedure, (wait-and-see prescribing), where a prescription is written but parents are told not to fill it unless the child fails to improve or gets worse 48 hours after the appointment.

The UK and many European countries, recommend the WASP approach and a new study, by researchers at Yale and Vanderbilt universities, prove that the principle works.

For the study when doctors examined about 300 children who were taken to emergency rooms with an ear ache, half of the children's parents got a wait-and-see prescription for antibiotics, while the other half were told to fill their prescriptions immediately.

All the children received ibuprofen and eardrops for pain.

The researchers found that around two-thirds of parents in the wait-and-see group did just that and the children recovered just as quickly from their earaches as those who received antibiotics immediately.

Most doctors agree with the WASP approach and are not surprised that the approach was successful; most also say the selective use of antibiotics is important because their overuse can have an impact on drug resistance.

Experts agree and point out that using less antibiotics especially in children will help maintain the drug's ability to work for them in the future when they may be essential.

Lead author, Dr. David Spiro, says it is clear that the overuse of antibiotics has led to many of the resistant infections now at large.

Spiro, who now heads Pediatric Emergency Medicine at Doernbecher Children's Hospital and Oregon Health and Science University in Portland, says that there are some children who shouldn't be given a wait-and-see prescription.

They include babies under 6 months of age, children with chronic ear infections, and children who appear seriously ill.

The study findings are published in the Sept. 13 issue of the Journal of the American Medical Association.