Aside from the common cold, ear infections are the most commonly diagnosed ailment in children in the United States.
Recently, the American Academy of Pediatrics (AAP) revised the treatment plan for acute otitis media
(AOM), or middle ear infections. AOM is the most common bacterial illness in children. These guidelines outline new standards for diagnosis and treatment, including pain management.
In short, the AAP wants doctors to distinguish between an ear infection and ear inflammation, and to treat a child’s ear pain before prescribing antibiotics.
“There are significant concerns about the rising rate of antibiotic resistance, as we know that people are using antibiotics too often,” said Children’s National Health System's Brian Reilly, MD, who is an active clinical researcher with specialized interests in hearing loss, cochlear implants, otitis media, obstructive sleep apnea, and chronic tonsillitis.
The new guidelines prioritize pain relief, especially within the first 24 hours. After that, the guidelines suggest that it is appropriate for most children to wait 48-72 hours to see if they can fight the infection without antibiotics. Additionally, if a child needs antibiotics, amoxicillin should be the first choice.
“The AAP put these guidelines in place so that both doctors and patients understand how best to treat ear infections and how to avoid unnecessary use of antibiotics,” said Dr. Reilly.
Nonetheless, even the new guidelines provide for a few instances in which antibiotics should be prescribed immediately. For example, children younger than 6 months, and children 6 months to 2 years old with certain or suspected AOM with severe symptoms like a ruptured ear drum, moderate to severe ear pain for 48 hours, and high fevers of 102.2 degrees Fahrenheit should not delay the start of antibiotics. In addition, the guidelines highlight that when antibiotics are not prescribed, it is critical to ensure patients have close follow-up appointments in case the child gets sicker.
Dr. Reilly said these new guidelines are just a framework and are not absolute, but are in place to ensure the highest standard of care.
As parents, what you do think of the new guidelines?