Does my child need antibiotics for an ear infection?

Antibiotics are a two-sided sword (can you tell I was sword-fighting with my son earlier today?). When used appropriately, antibiotics can be life-saving, reduce illness intensity and duration and expedite healing. However, used inappropriately, antibiotics can lead to bad side effects such as vomiting, and diarrhea, allergic responses (including anaphylaxis), increased bacterial resistance which means that antibiotics won’t work when you need them, and are a waste of money.

The CDC estimates that 30% of antibiotics are not needed!

The American Academy of Pediatrics has issued recommendations that all providers be good stewards of antibiotics (ie, don’t prescribe them if not needed). Ear infections in children are an enormous source of antibiotic over-prescription. 60% of ear infections will clear without treatment in 24 hours, and 80% will clear without treatment in 48 to 72 hours!

So when should a parent seek treatment for their child’s ear infection?

According to the American Academy of Pediatrics guidelines, all infants less than six months should be treated for an ear infection.

The guidelines recommend treatment for children between six months and two years IF the child has a high temperature, bilateral ear infections and moderate to severe distress.

Children between six months and two years with only a low temperature, one sided ear infections and mild symptoms can be observed for 48 hours for improvement.

Children over the age of two generally do not need antibiotics — although there are exceptions including children with speech delays, history of prior frequent ear infections, and facial abnormalities.

All children should be treated for their symptoms — they don’t need to be in pain! Many studies have shown that the alternating use of Tylenol and Motrin can ease symptoms — and this treatment alone can decrease the unnecessary use of antibiotics.

All ear infections lead to fluid accumulation in the middle ear called effusions. These effusions can last for up to three months after an ear infection — and can also predispose children to more ear infections. Antibiotic use, however, does not effect the duration of these effusions one way or the other. If you are concerned that your child is having trouble hearing, please have them evaluated by their doctor.

Risk factors that predispose children to ear infections include: age less than two, family history, presence in daycare, exposure to tobacco users, air pollution and pacifier use.

Protective factors against ear infections include breastfeeding and keeping your infant away from other children (not realistic for working parents, or parents with more than one child).

As a parent, if you suspect your child of any age has an ear infection, do not hesitate to relieve their pain! If your child is less than two, please call their pediatrician for an evaluation. For children over two, it is ok to wait a few days before calling.

Personalized Pediatrics of Maine strives to be the best Pediatric office in the state of Maine!