Watch and Wait for Ear Infections?

Avoiding complications from spreading bacteria is one of the most important reasons to treat ear infections with antibiotics. Mastoiditis, an infection of the skull bone behind the ear, is the most common serious complication.

A major study published in the August 2001 issue of the Pediatric Infectious Disease Journal compared children in the US, UK, Canada, and Australia (where more than 96% of acute ear infections in children are treated with antibiotics) with children in the Netherlands, Denmark, and Norway (where only 31% to 76% of acute ear infections are treated with antibiotics).

Complications are indeed more common when people ‘watch and wait’ before treating many ear infections — but the increased complications only totaled 2 extra cases of mastoiditis per 100,000 children per year.

Adverse reactions to antibiotics can be a bigger problem than spreading ear infections.

Clearly some ear infections are best treated with antibiotics, but I favor watching and waiting (with good pain treatment for the child) whenever it makes clinical sense.

I hope the days of knee-jerk antibiotic treatment for ear infections are coming to an end.

Published on: August 28, 2001
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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My daughter had an ear infection (bulging ear drum).The emergency doctor prescribed antibiotics. Her symptoms were high temperature head ache sickness and tummy ache.On the second day of antibiotics, we took her back to our GP as she was not any better.They referred us to AE. After spending 6 hours there, we were sent home and told to stop the Antibiotics, being informed they were the wrong ones! 30+ hours later she crashed and the ear infection was found to have caused meningitis! Please always remember prevention is better than cure and always be guided by your instincts and stay true to them always