What’s the best treatment?
Your pediatrician will check your child’s ears with an otoscope, enabling him to detect infl ammation and fLuid. What a doctor can’t determine is whether the ear infection is viral or bacterial.
Antibiotics have no effect on viruses— which cause up to one-third of all ear infections—or even on some types of bacteria that have become resistant due to overuse of antibiotics. Another downside: Antibiotics kill off beneficial organisms in the body and, hence, can lead to rashes as well as gastrointestinal problems like diarrhea and nausea. Not long ago, antibiotics were prescribed if there was even a hint of an ear infection.
Recent research published in the Journal of the American Medical Association, however, has shown that most ear infections resolve on their own in two to three days without antibiotics.
This study found that the “WASP” approach— a “wait-and-see prescription” for antibiotics, which parents are asked not to fi ll unless the child isn’t better in 48 hours—substantially reduced unnecessary antibiotic use. “In the U.S., there seems to be a fear that if a child doesn’t get antibiotics, he won’t get better,” says David M. Spiro, MD, director of pediatric emergency medicine at Doernbecher Children’s Hospital at Oregon Health & Science University in Portland, and one of the coauthors of the study. “But in Europe, the observational approach is used by doctors 80 percent of the time, and has proven very successful and not dangerous.”
Spiro believes the WASP method is the smart way to go in most cases. Of course, there are exceptions to this observational WASP approach. Waiting two days to fi ll an antibiotic prescription just isn’t a realistic option in some cases. The American Academy of Pediatrics recommends antibiotics for children less than 2 years old who have a fever over 102 degrees, have fluid in their ears and have had a rapid onset of ear-infection symptoms.
Older toddlers with severe earache or high fever should also be prescribed antibiotics. For everyone else, waiting and seeing (though difficult for parents) is the best way to go. If your child is better in 48 hours, tear up the prescription. If not, head to the pharmacy—but not before calling your pediatrician, who may want to examine your child again. One more thing to remember: “Antibiotics don’t address ear pain,” reminds Spiro. “It’s important that parents ask their doctors about prescribing ear drops to reduce the earache.” Also ask about children’s ibuprofen, which can relieve your child’s ouch factor and promote pain-free sleep.
NEXT: THE BEST STRATEGIES TO PREVENT EAR INFECTIONS