For many children suffering from acute otitis media, the most appropriate treatment is "watchful waiting" instead of using antibiotics immediately, researchers at Ben-Gurion University have said.
Currently, watchful waiting is recommended for children over six months of age with mild to moderate symptoms or an uncertain AOM diagnosis.
The researchers said that the method could play a major role in helping fight the development of treatment-resistant bacteria.
"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," said Dr. Eugene Leibovitz, lead author of the review, who is a BGU professor and works in the Pediatric Infectious Diseases unit at Soroka University Medical Center.
The review notes that since the introduction of a polysaccharide conjugate vaccine to prevent infections from seven serotypes of the bacteria named Streptococcus pneumoniae, the number of AOM infections associated with these bacteria has decreased.
However, AOM infections from bacteria not covered by the vaccine are on the rise. A new vaccine, one that prevents infections caused by 13 serotypes of S. pneumoniae, was recently introduced in routine use in many countries.
"Appropriate antibiotic treatment and vaccine-resistant bacteria remain a problem in managing children with AOM. With selective guidelines-recommended use of antibiotic therapies and employing watchful waiting in non-critical cases, hopefully, we can discourage the emergence of other treatment-resistant bacterial strains," said Leibovitz.
The review is published in the scientific journal Expert Review of Anti-Infective Therapy.