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Antibiotics and the Aware Parent

Written by Claudia Anrig, D.C.   
Tuesday, 01 June 2004 00:00
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Acute Otitis Media is the most common upper respiratory condition treated in pediatric offices and the treatment of this condition continues to be the most controversial in the medical community (1-3).

The majority of children suffering from Acute Otitis Media will automatically be placed on antibiotics despite growing evidence that suggests there’s only a marginal benefit from this form of care (4).

The pediatric community is being confronted primarily by mounting evidence that the standard use of antibiotics may be an outdated practice with little value and what appears to be greater risk to the child.

When prescribing antibiotics for your child your pediatrician should be willing to answer the question, “Does this case warrant a prescription”?

Antibiotics and the Aware ParentLet’s consider an observation published recently by the American Academy of Pediatrics and the American Academy of Family Physicians:

“Each course of antibiotics given to a child can make future infections more difficult to treat. The result is an increase in the use of a larger range of—and generally more expensive— antibiotics. In addition, the benefit of antibiotics for Acute Otitis Media is small on average and must be balanced against potential harm of therapy. About 15 percent of children who take antibiotics suffer from diarrhea or vomiting and up to 5 percent have allergic reactions, which can be serious or life threatening. The average preschooler carries around 1 to 2 pounds of bacteria – about 5 percent of his or her body weight. These bacteria have 3.5 billion years of experience in resisting and surviving environmental challenges. Resistant bacteria in a child can be passed to siblings, other family members, neighbors, and peers in group-care or school settings.” (5)

Scientific Evidence

Scientific evidence puts forth the following information:

  • Children with high temperature or vomiting improved after an average of three days.
  • Children with high temperature or vomiting were likely to benefit from antibiotics, although it’s still reasonable to wait 24 to 48 hours since many children will improve when left to their body’s own natural defenses.
  • Children without high temperature or vomiting were not expected to benefit from immediate antibiotics.

Considering this information it’s best to take an option to observe stance since 80 percent of children with Acute Otitis Media get better without antibiotics within 48 to 72 hours (6).

With this scientific evidence mounting, ask yourself a few questions:

Will my pediatrician continue to prescribe antibiotics to my child based on his or her old programming and habits despite growing evidence that suggests antibiotics make little difference?

Does my pediatrician continue to have concerns that there’s a risk for dangerous complications, such as Acute Mastoiditis, despite the fact that it’s documented as a “rare occurrence” (2)?