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A newly released report from the Agency
for Healthcare Research and Quality (AHRQ) suggests that children
may not always need antibiotics to treat a middle ear infection (otitis
media).
Researchers from the Southern California/RAND Evidence-based
Practice Center (EPC) found some interesting findings, including:
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Nearly two-thirds of children with uncomplicated
ear infections recover from pain and fever within 24 hours of diagnosis
without antibiotic treatment
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Over 80% recover within 1 to 7 days.
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Approximately 93% of children treated with antibiotics
recover within 1 to 7 days.
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Researchers also found that the newer and more
costly antibiotics, such as cefaclor, cefixime, azithromycin, or clarithromycin,
provided no additional benefit to children than amoxicillin.
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Amoxicillin caused fewer side effects than the
other antibiotics as well.
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The EPC also found no evidence that short-duration
(5 days or less) versus long-duration therapy (7-10 days) made a difference
in the clinical outcome for children over 2 years of age.
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More than 5 million cases of acute ear infections
occur annually, costing about $3 billion.
The report points out that in other countries otitis
media is not always treated with drugs at the first sign of infection.
Rather, in children over the age of 2 years, the norm is to watch and
see how the infection progresses over the course of a few days.
The report notes that in the Netherlands the rate
of bacterial resistance is about 1%, compared with the US average of around
25%.
The Summary of the findings of this study, entitled
Management of Acute Otitis Media Summary, Evidence Report/Technology Assessment
15, is available by calling the AHRQ Publications Clearinghouse at 1-800-358-9295.
Agency
for Healthcare Research and Quality, Rockville, MD, August 9, 2000
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