Physicians Advised To Delay Use of Antibiotics for Earaches to Deter Resistance

The American Academy of Pediatrics and the CDC have developed new guidelines that advise physicians to delay prescription of antibiotics for two to three days for many children with earaches to help reduce antibiotic resistance, the Cox/Contra Costa Times reports. Physicians write about 10 million prescriptions for antibiotics each year for children with earaches, which accounts for almost half of all antibiotic use among preschool children. Most earaches are caused by viral, not bacterial, infections, and 81% heal without medication, according to the Agency for Healthcare Research and Quality. According to the new guidelines, physicians should:

Wait two to three days before they prescribe antibiotics for children older than six months without certain diagnosis of an ear infection;
Prescribe antibiotics for children older than two years with ear infections for five days, rather than seven to 10 days;
Immediately prescribe antibiotics for children younger than six months with earaches;
Immediately prescribe antibiotics for children younger than two years with certain diagnosis of an ear infection; and
Immediately prescribe antibiotics to children between six months and two years without certain diagnosis of an ear infection but with a fever higher than 102 degrees or severe ear pain.

Physicians may write prescriptions for antibiotics and advise parents to wait two to three days before they administer them. In addition, physicians may also ask parents to call in orders for antibiotics over the telephone, or return for follow-up visits. Physicians also should recommend over-the-counter pain medications to treat earaches in children, Dr. Richard Rosenfeld, a pediatric ear, nose and throat specialist at Long Island College Hospital, said. "You're not getting a lot of bang for your antibiotic buck with this disease," Rosenfeld, who has helped with the development of the new guidelines, added. "Parents often have the expectation that their child is sick and needs an antibiotic to get well, and some really put the pressure on. But now we can say, 'It's not just me. It's the CDC and the Academy of Pediatrics,'" Atlanta pediatrician Dr. Gerald Reisman said. The Academy of Pediatrics will launch a "watchful waiting" campaign to promote the new guidelines nationwide this fall (Wahlberg, Cox/Contra Costa Times, 6/8). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.