Ear infections are the number one reason that antibiotics are prescribed for children. But we know that 70 to 90 percent of kids with ear infections would recover well without antibiotics. The problems are that we don’t know which kids will recover without antibiotics and that, in the mean time, ear infections hurt!
Perhaps the answer is a SNAP (a safety-net antibiotic prescription). I do this frequently in practice, and have done so with success for more than eight years.
A study in the September 2003 Pediatrics had doctors examine children with acute ear infections. If the children were at least 12 months old, had no fever over 101.5, had not just gotten over another ear infection, and had no signs of a bacterial infection beyond just the ears, the parents were given a SNAP, and instructed not to fill the prescription unless the symptoms either increased or were still there after 48 hours. In the meantime, they were to give the child oral pain relievers or topical drops to control the pain.
Only 31 percent ever filled their antibiotic prescriptions. And 78 percent felt the pain relief was effective. Most parents in the study would like to use this approach again. This approach could make a huge difference in antibiotic use and antibiotic resistance.
I am very glad that gentle ear drops are now available over-the-counter to help soothe those hurting ears while their bodies, with or without the help of antibiotics, are doing the healing.
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