I was standing at the counter of my local CVS waiting to ask a contact lens solution question. (Was the generic solution I was holding comparable to the AOSept I normally buy?) A young mother was asking the pharmacist to check her daughter’s prescription. The doctor had spent a lot of time calculating the dose and she was nervous. She explained that it was for “the start of an ear infection.” When the pharmacist moved away to get a book, I swooped in. I couldn’t help it.
“You know the American Academy of Pediatrics warns against using antibiotics for an emerging ear infection, right? My pediatrician follows those guidelines and takes a wait-and-see approach,” I said. The woman looked at me like I was a bug and told me that her daughter was in so much pain. “She just cries.” That’s what numbing drops and Tylenol is for, I told her. And then I gave up. I didn’t try and explain that antibiotics take 24 hours to work — and that’s if the ear infection was bacterial, which is may not be. That the antibiotics couldn’t take the pain away immediately.
Regular readers of my blog may be sick of me beating this drum. I have blogged (see this one and this one) about this issue — overuse of antibiotics — for a while now. Except now I know someone who is dealing with the fallout. It’s a kid who has a bone infection he can’t shake. He’s had several operations and multiple courses of drugs, but the bacteria, so far, is resistant to everything that medical science throws at it. Is it because we’ve been dosing our food supply (cows and pigs, for instance) with antibiotics? Is it because of doctors who give out antibiotics like they are candy? Is it simply a fluke? I don’t know, but I will take the opportunity again to remind people that, as I told that random woman at CVS, the AAP is asking doctors to take a wait-and-see approach with ear infections. They don’t want most kids with ear infections to get antibiotics.
Why not? One recent study says it best: “However, unlike other bacterial infections, the vast majority of children with [acute otitis media or ear infections] recover within a week without antibiotics. Antibiotics also have known harms and antibiotic resistance is increasing worldwide.”
You can read a simple story about the AAP’s guidelines here, but in a nutshell parents should be willing to let their children’s immune systems do a little work and try and clear the infection on their own. You can try some numbing drops or some Tylenol or Motrin if the pain is too much. Of course, it goes without saying that every child is different and you should consult with your doctor before choosing a treatment path. I’d suggest asking your doctor about the AAP’s guidelines. If they don’t know about them? I think it’s time to find a new doctor, but that’s just me.