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Antibiotics a Mixed Bag for Kids' Ear Infections: Analysis
Date:11/16/2010

formation in the study. The average cost of an ear infection is $350 per child, which ends up costing the entire health-care system about $2.8 billion annually.

The current review, conducted by the Southern California Evidence-Based Practice Center, looked at the diagnosis, management and outcomes of ear infections in 135 studies done from 1999 to 2010 on acute otitis media.

Coker said the purpose of the analysis was "to provide the best evidence for the American Academy of Pediatrics (AAP), since they are revising their guidelines for ear infections in children."

The new analysis also found that when doctors use an otoscope to look in a child's ear, the signs of a bulging tympanic membrane and redness are accurate ways to diagnose an acute ear infection.

In addition, the review confirmed what doctors had suspected would happen with the introduction of the pneumococcal conjugate vaccine (PCV7): the number of infections with bacteria covered in that vaccine went down. Unfortunately, ear infections caused by other bacteria increased.

None of the studies reviewed looked at the potential long-term harm of antibiotic use, such as antibiotic resistance, the researchers noted.

Results of the analysis are published in the Nov. 17 issue of the Journal of the American Medical Association.

Experts noted that this review, like many analyzing already published studies, have some inherent limitations.

"The problem with these kind of reviews is that most of the studies are old," said Dr. Alejandro Hoberman, chief of the division of general academic pediatrics at Children's Hospital of Pittsburgh. "We need better studies with clearer guidelines on diagnostic inclusion, and more stringent questions about antibiotic use," he added, noting such research is currently underway.

Hoberman, who's on the AAP committee for developing new guidelines, said there will be a new focus on improving the diagnosis of ear infections,
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