Are Antibiotics really necessary for children with Ear Infections?

Children in day care probably get more antibiotics prescribed for them than children who stay at home.

A May 2001 Danish study followed children from birth in 1997 to the age of two years and found that enrollment in a day care center doubled a child’s likelihood of being prescribed an antibiotic.

Whether this is true in U.S. day care centers is not currently known. But at least in Denmark, the more time parents spend at home with their children (parents in Denmark get six months of parental leave), the less likely they are to have antibiotics prescribed for their kids in the first two years of life.

The authors of the study were unable to conclude whether the increased use of antibiotics was the result of actual increases in illness, or merely from parental demands for antibiotic treatment. They did discover that children with older siblings were less likely to get antibiotics, but again they couldn’t figure out whether this was due to the increased immunity likely in younger siblings or to the parents’ tolerance of illness without insisting on antibiotic treatment.

One of the most common ailments of childhood, and perhaps one of the most common reasons for the unnecessary prescription of antibiotics, is ear infections, serous otitis media. (Serous otitis media is distinguished from the otitis media that involves bacteria in the middle ear without the presence of fluid.) This is an ailment in which kids get fluid in their ears, usually for much the same reasons they get runny noses.

Ears make fluid in the same way the nose does, it just doesn’t fall out as easily as it does out of the nose. It can take up to a month to dissipate. So what are you supposed to do about it? In most cases, nothing except wait for it to go away, but parents often insist on getting antibiotics for it, and doctors give in when they shouldn’t.

The only time when antibiotics might be necessary for otitis media is when the fluid is still present after several months, it’s best to see a doctor a few months after an infection to see if that has happened. But usually it doesn’t happen.

Otitis media almost always gets better by itself.