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Antibiotics for Kids' Middle Ear Infections: Not Always the Best Answer

A new study led by CHEO's Dr. Nicole Le Saux confirmed last month that antibiotics to treat middle ear infections in children under the age of 6 years are not always the best solution.

Researchers found that there was a slight benefit to using the antibiotic amoxicillin with middle ear infections, but that many children also get better without the use of an antibiotic early in the infection.

According to Dr. Le Saux, “Every child is unique and needs to be treated on an individual basis. However this study found that after 14 days, otherwise healthy kids who received antibiotics were only about 9% better off than those who did not receive antibiotics. For the average child, this means that in the first day or two, their doctor may recommend waiting before using antibiotics in order to see if the child gets better on their own.”

Dr. Le Saux's research team looked more than 500 children with ear infections. They were randomly assigned to two groups: a group to receive the antibiotic amoxicillin and a group to receive a placebo (prescription without medicine). They followed up with the children 4 times over the 2 weeks after a doctor had seen them. Although the children without antibiotics were more likely to have fever and be more uncomfortable for the first two days, by the end of 14 days, 84.2% of kids with placebo and 92.8% of kids on amoxicillin were better.

These findings support a growing movement among physicians to wait and see before prescribing antibiotics. The trend to slow down the use of antibiotic stems from the growing concern over antibiotic resistant bacteria which can develop when antibiotics are not properly used. “Antibiotics remain an important option for treating ear infections in children. We feel it is important however to give physicians and families strong research information to make the right choices for children,” continued Dr. Le Saux.

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