Experts say the routine use of antibiotics against pediatric ear infections produces little health benefit while contributing to the spread of drug-resistant bacteria. The article evaluated the results of seven different studies conducted over the past 30 years. They found that while antibiotics were linked to short-term decreases in the duration of pain or fever in patients in a few (but not all) of the studies, no

long-term (more than six weeks) benefits are reported. All seven studies concluded that children recovered from ear infections at roughly similar rates, regardless of type of treatment.

The authors believe the frequent use of antibiotics for common ear infections raises risks that children will harbor drug-resistant bacteria during subsequent illness. They point out that children whose previous ear infections were treated with antibiotics have a rate of Ampicillin (amoxicillin)-resistant bacteria that is three times higher during subsequent otitis media episodes In extreme cases, deaths from drug-resistant meningitis have been linked to built-up antibiotic resistance traced to previous treatment for ear infection.

The experts advocate that except in severe, recurrent cases, infants and toddlers with ear infections should be initially treated with 'symptom-relieving' drugs such as Acetaminophen and nasal decongestants. If symptoms persist past three days, antibiotics can be considered at that time.

JAMA November 26,1997;278(20):1643-1645

COMMENT: It is incredibly reassuring to find that the largest medical journal in the world published an editorial that is actively encouraging physicians to stop ALL antibiotics (except in cases of severe and recurrent infections) for the most commonly treated infection in childhood. This is a huge step in the right direction. Eventually the truth rises to the surface and can not be ignored. The next step will be to publish the reasons why these kids are getting ear infections to begin with. The studies have been done and the work is quite clear. Food allergies are the number one cause of recurrent ear infections in children. The most common item would be milk. Simple elimination of milk will stop the infections in nearly 50% of kids. Stopping sugar and juices will eliminate 50 to 70% of the remaining infections.