Researchers Call For Prudent Use Of Antibiotics In Young Kids

Young children who are given antibiotics to treat acute ear infections are 20% more likely to suffer from recurrent ear infections, finds research published on bmj.com today.

This survey of parents whose young children took part in a Dutch trial of antibioitics for acute ear infections shows that nearly two thirds (63%) who were given antibiotics had a recurrence of the infection within three years. This compares with only a 43% recurrence rate in children who were given a placebo at the time of initial infection.

About Otitis Media
Middle ear infection, or otitis media, is a common type of infection that may or may not accompany the infections of nose and throat. It is the infection of any part of the middle ear.

The study is the first to assess the long term effects of antibiotics in children with acute otitis media (ear infection) and supports calls for judicious prescription of antibiotics.

Acute otitis media is one of the most common infections in childhood and is the most frequent reason for children to take antibiotics. Current guidelines recommend prescribing antibiotics to children with severe illness and in those younger than two years of age with severe infection. For most other children with acute otitis media, initial observation is recommended.

The trial was conducted across 53 general practices in the Netherlands and included 168 children aged six months to two years of age.

Anatomy of Ear and Hearing
Ear converts sound waves into electrical impulses that are transmitted to the temporal lobe of the brain through the auditory nerve. It consists of outer, inner and middle sections.

In 2000, three and a half years after the start of the trial, parents of the participating children were sent a questionnaire asking if their child had suffered a recurrence of acute otitis media. In the amoxicillin group, 47 out of the 75 children had suffered at least one recurrent episode, compared with only 37 out of 86 in the placebo group.

This means that children in the amoxicillin group had a 2.5 times higher risk of recurrent acute otitis media than children in the placebo group.

Prescribing Antibiotics for ENT Infections is Unnecessary
A new study has found that an unwarranted use of antibiotics is on the high that are prescribed to curb possible complications after upper respiratory tract infection, sore throat, or ear infection.

The survey was likely to be unbiased because it included most (70%) of the parents, and because none of them had known at the time of the trial which treatment - either antibiotic or placebo - their children had received. The association remained even after adjusting the results for other factors, such as allergy and a previous tendency to have recurrent ear infections. It should be noted however that 30% of children in the placebo group had to undergo ear, nose, and throat surgery on initial infection, compared with only 21% in the amoxicillin group.

The researchers suggest that the difference in recurrence rates between the two groups could be due to a weakening of the children’s natural immune response system, as a result of taking antibiotics at the initial stage of infection. They argue antibiotic use may cause an ‘unfavourable shift’ towards the growth of resistant bacteria.

Antibiotics Overload For Kids Questioned
Acute otitis media (AOM), or middle ear infection, is the most common bacterial illness in children and the one most commonly treated with

They also suggest that, whilst antibiotics may reduce the length and severity of the initial ear infection, their use may encourage doctors’ attendance in future episodes and antibiotic resistance.

This is another argument for judicious use of antibiotics in children with acute otitis media, they conclude.

Source-BMJ
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