That Earache May Have Last a Little Longer

Researchers recommend monitored waiting instead of antibiotic treatment for middle ear infections in children

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Researchers from Ben-Gurion University of the Negev (BGU) suggest that the immediate use of antibiotics to treat middle ear infections is not always necessary.

This finding is part of a review published in the journal Expert Review of Anti-Infective Therapy.

The review states that middle ear infections, or Acute Otitis Media (AOM), can be treated with watchful waiting in the large majority of cases without the risk of long-term, adverse effects. The authors warn that antibiotic treatment is essential in some cases. However, watchful waiting is recommended for children six months of age and older with mild to moderate symptoms or an uncertain AOM diagnosis.

The overuse of antibiotics can lead to the development of treatment-resistant bacteria. According to the review's authors, treating AOM with watchful waiting would reduce the use of antibiotics and thus reduce the chances of generating drug-resistant bacterial strands.

According to Dr. Eugene Leibovitz, lead author of the review, BGU professor, and employee at Soroka University Medical Center's Pediatric Infectious Diseases unit, "For years, antibiotic therapy was the norm for any child presenting with AOM symptoms. However, we soon learned that there are problems with this strategy. While the antibiotics were killing off most of the AOM-causing bacteria, the few bacteria that managed to survive have developed resistance to that treatment."

The review states that the number of AOM infections associated with seven serotypes of the bacteria Streptococcus pneumonia has gone down since the introduction of the polysaccharide conjugate vaccine. Despite this decrease, the number of AOM infections from bacteria not covered by the vaccine is increasing.

Says Leibovitz, "Appropriate antibiotic treatment and vaccine-resistant bacteria remain a problem in managing children with AOM. With selective guideline-recommended use of antibiotic therapies and employing watchful waiting in non-critical cases, hopefully we can discourage the emergence of other treatment-resistant bacterial strands."

Reviewed by: 
Review Date: 
December 19, 2010
Last Updated:
December 20, 2010