Antibiotics Recommended for Toddlers with Ear Infections

 In a surprising deviation from the American Academy of Pediatrics, a team of researchers has published research stating that all children affected with acute otitis media should receive antibiotics. This research is in direct contrast with the American Academy of Pediatrics’ recommendation that children be given antibiotics as little as possible. The guidelines released by the AAP in March of 2013 clearly state that children aged 6 months to 24 months should not be treated with antibiotics for a unilateral ear infection. The team of researchers conducted two blind pilot trials in Pennsylvania and Finland, randomly assigning children diagnosed with acute otitis media to receive amoxicillin or a placebo medication.

General practitioners may be unlikely to prescribe antibiotics to children, except in the most severe of cases. Pharmacies can lessen the burden on parents by ensuring that prescriptions that are called in are filled promptly, lessening the wait time for parents to get medication for their sick child. Often, children with ear infections will be inconsolable, and understandably. Children are unable to vocalize their pain except for crying, and pharmacies can ensure fast and friendly service to ease the stress that having a child with an acute ear infection can cause parents or caregivers. Pharmacies can also provide literature on how to provide natural relief from the pain of ear infections, what causes ear infections, and how to best treat them in the future. Some children may get chronic ear infections, and providing the contact information of a community ENT pediatrician can be beneficial.

Pharmacists should take care to listen to parent and caregiver concerns about the possible side effects from antibiotics. Having literature available to answer frequently asked questions can be helpful. The most common side effects of antibiotics are upset stomach, diarrhea, heartburn, and abdominal pain. Children may not be able to vocalize the severity of their side effects, and parents should be reminded to keep a close eye on their children throughout the duration of their treatment with antibiotics. Amoxicillin can cause severe side effects in some cases, such as confusion, bruising, bleeding, and jaundice of the skin or eyes. Vomiting and diarrhea indicate severe side effects, and children should be taken to the emergency room promptly for treatment, as it is simple for small children to dehydrate.

Ear infections in children are quite common. These research findings are not endorsed by the AAP; however, some general practitioners may choose to prescribe children antibiotics for acute ear infections given these new findings. Antibiotics were found to fail at treating the infection 14% of the time in a unilateral ear infection, and 25% of the time in cases where the infection was bilateral. Children treated with a placebo experienced 40% medication failure to treat a unilateral infection, with 59% of bilateral infections unable to be treated by placebo. Though the supporting evidence bolsters the research findings, it is unlikely that general practitioners will prescribe antibiotics unless a case is severe. Pharmacists should be aware of these findings, and be able to offer counsel to parents if need be.