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
Researchers from the Southern California/RAND Evidence-based
Practice Center (EPC) found some interesting findings, including:
Nearly two-thirds of children with uncomplicated
ear infections recover from pain and fever within 24 hours of diagnosis
without antibiotic treatment
Over 80% recover within 1 to 7 days.
Approximately 93% of children treated with antibiotics
recover within 1 to 7 days.
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.
Amoxicillin caused fewer side effects than the
other antibiotics as well.
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.
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
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.
for Healthcare Research and Quality, Rockville, MD, August 9, 2000