wendibird22
02-25-2013, 11:22 AM
Just saw this article in my local paper and thought I would share since abx for EI gets asked frequently on the BBB.
http://www.democratandchronicle.com/usatoday/article/1935493
According to the guidelines, children need immediate antibiotics if they have a severe ear infection (defined as either a fever of 102.2 degrees or higher or significant pain); a ruptured ear drum with drainage; or an infection in both ears for kids 2 or younger.
These account for fewer cases, but "we know from studies that they get the most benefit from an antibiotic right away," says Rosenfeld. "Kids without these symptoms tend to get well on their own and can be safely observed for a few days."
Observation doesn't mean sitting back and doing nothing, however. Ibuprofen or acetaminophen should be given to relieve pain. "If it's going to improve, it will happen in 72 hours. If a child's symptoms get worse or don't improve in that time, they should be given antibiotics," he says. In studies where the observational option has been offered, two out of three kids get better without an antibiotic, he adds.
Rosenfeld notes that other conditions, such as a new molar in a toddler's mouth, a cold, sore throat or viral inflammation can all result in ear pain. Physicians are encouraged to examine the child's ear drum to make an accurate diagnosis. "If it's big and bulging, that's a sign of a middle-ear infection," he says.
The new recommendations also note that:
â?¢ Multiple studies provide strong evidence that exclusively breast-feeding for a minimum of four months reduces overall episodes of ear infections.
â?¢ Eliminating exposure to passive tobacco smoke may reduce ear infections during infancy.
â?¢ Ear-tube surgery is an option for kids with recurrent acute middle-ear infections; it has been shown effective, especially for those who hold on to fluid between infections.
http://www.democratandchronicle.com/usatoday/article/1935493
According to the guidelines, children need immediate antibiotics if they have a severe ear infection (defined as either a fever of 102.2 degrees or higher or significant pain); a ruptured ear drum with drainage; or an infection in both ears for kids 2 or younger.
These account for fewer cases, but "we know from studies that they get the most benefit from an antibiotic right away," says Rosenfeld. "Kids without these symptoms tend to get well on their own and can be safely observed for a few days."
Observation doesn't mean sitting back and doing nothing, however. Ibuprofen or acetaminophen should be given to relieve pain. "If it's going to improve, it will happen in 72 hours. If a child's symptoms get worse or don't improve in that time, they should be given antibiotics," he says. In studies where the observational option has been offered, two out of three kids get better without an antibiotic, he adds.
Rosenfeld notes that other conditions, such as a new molar in a toddler's mouth, a cold, sore throat or viral inflammation can all result in ear pain. Physicians are encouraged to examine the child's ear drum to make an accurate diagnosis. "If it's big and bulging, that's a sign of a middle-ear infection," he says.
The new recommendations also note that:
â?¢ Multiple studies provide strong evidence that exclusively breast-feeding for a minimum of four months reduces overall episodes of ear infections.
â?¢ Eliminating exposure to passive tobacco smoke may reduce ear infections during infancy.
â?¢ Ear-tube surgery is an option for kids with recurrent acute middle-ear infections; it has been shown effective, especially for those who hold on to fluid between infections.