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Pediatrics Group Issues New Ear Infection Guidelines
Date:2/25/2013

If children who are being observed don't improve within 48 to 72 hours from when symptoms first began, the guidelines recommend beginning antibiotic therapy.

Previous guidelines recommended giving antibiotics for ear infections in children age 2 and under. The new guidelines suggest that children aged between 6 months and 23 months can be observed with close follow-up as long as they don't have severe symptoms.

Another key component of the new guidelines is pain management. "Antibiotics take 24 to 48 hours before they start to improve signs and symptoms, so if a child has fever or pain, it's important to place them on [pain-relieving or fever-reducing medications]," Samuels said.

The guidelines also confirm that amoxicillin should be the antibiotic of choice unless the child is allergic to penicillin, or if the child has been treated with amoxicillin during the past month.

The new guidance from the AAP also states that children, even those with recurrent infections, shouldn't be on long-term daily antibiotics to try to prevent infections from occurring.

Children who have three or more ear infections in a six-month period, or four or more infections in a one-year period (with at least one infection occurring in the previous six months), should be referred to an ear, nose and throat specialist. That's because children with such frequent infections may need to have tubes placed in their ears for better fluid drainage.

Finally, the guidelines also recommend staying current on your child's vaccine schedule, particularly with the pneumococcal conjugate vaccine (PCV), and the annual flu shot.

"Studies show that anything that decreases viral infection will decrease the incidence of [ear infections]," Lieberthal said.

Both Lieberthal and Samuels said that parents increasingly understand the importance of trying to reduce the use of antibiotics. First, because it exposes their child to unnecessary risks from side effect
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