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New guidelines from American Academy of Pediatrics: Go easy on Antibiotics for children's ear infections

Pediatrician Elsa Maldonado examines a child at her office.
Pediatrician Elsa Maldonado examines a child at her office.
Jesus Alcazar/AFP/Getty Images

The number of ear infections in young children have dropped -- but not the number of antibiotic prescriptions issued for them. That's worried the American Academy of Pediatrics which on Monday issued new guidelines for how to treat a child’s ear infection. Its suggestion: Don’t leap to antibiotics.

The American Academy of Pediatrics is concerned with the growing incidences of antibiotic resistance to the organisms that cause ear infections – in medical terms this is called Acute otitis media (AOM).  The report, published today in Pediatrics, reviewed data on cases between 1990 and 2000 and found that while ear infections dropped from 25 million to 16 million, but use of antibiotics stayed flat.

“Each course of antibiotic given to a child can make future infections more difficult to treat,” the authors said .

The report explains the public health risks of overuse of antibiotics:

“The average preschooler carries around 1 to 2 pounds of bacteria – about 5 percent of his or her body weight. These bacteria have 3.5 billion years of experience in resisting and surviving environmental challenges. Resistant bacteria in a child can be passed to siblings, other family members, neighbors, and peers in group-care or school settings."

Should your baby or toddler come down with the AOM symptoms, the Academy suggests pain killers, rest and constant monitoring for at least 48 hours. If it doesn't clear up or symptoms are severe, stronger steps can be taken.  severe ear infection is one in which the child's fever is above 102.2 or the ear drum has ruptured and there is drainage.

Older guidelines used to call for pediatricians to routinely prescribe antibiotics for ear infections in children age 2 and under--and many still do.

The American Academy of Pediatrics now wants caregivers and pediatricians to only administer antibiotics to a child older than 2 if the severe symptoms do not improve in 48-72 hours. For infants under one year who may still be breastfeeding, the new guidelines strongly encourage exclusive nursing to help the baby fight the infection.