Ear Infections in Young Children Need Longer Course of Antibiotics

A new study reveals evidence that a longer course of antibiotics is more effective for treating ear infections in young children.

Anyone with young children knows that ear infections seem to be a rite of passage for children under 3 years of age. Although a short course of antibiotics may seem best to treat the infection and, indeed, be easier on the parents trying to administer the medication to their little one, the results of a new study are stating that a longer course of antibiotics is better for treating children’s ear infections.

Ear infections impact about 75% of children during their first year of life, stated the study authors in a recent press release out of the University of Pittsburgh. Children are more likely to get ear infections than adults because their Eustachian tubes are smaller and more level, making it difficult for fluid to drain out of the ear. Additionally, respiratory illnesses may cause the tubes to become swollen or blocked with mucus, making it even more difficult for fluids to drain from the ear. Children’s immune systems are not as developed as adults as well, and so it is harder for them to fight infections. According to the National Institutes of Health (NIH), common signs of ear infections in children include, “tugging or pulling at the ear(s); fussiness and crying; trouble sleeping; fever (especially in infants and younger children); fluid draining from the ear; clumsiness or problems with balance; and trouble hearing or responding to quiet sounds.”

The NIH also states that, “[Ear] infections are the most common reason why children are given antibiotics.” Although antibiotics are a common treatment for ear infections, the growing rate of antibiotic resistance has sparked concerns about their use. It was because of this that the researchers from the University of Pittsburgh embarked on their study of antibiotic use for pediatric ear infections.

Alejandro Hoberman, MD, chief of the general academic pediatrics division at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center said in the press release, “Given significant concerns regarding overuse of antibiotics and increased antibiotic resistance, we conducted this trial to see if reducing the duration of antibiotic treatment would be equally effective along with decreased antibiotic resistance and fewer adverse reactions.”

The researchers studied 520 children with ear infections, ranging in age from 9 months to 23 months. The children “were randomly selected to receive either a standard 10-day course of antibiotics or a shortened 5-day course of antibiotics followed by five days of placebos.”

The results of the study showed a 34% risk of treatment failure in the 5-day treatment course group and a 16% risk in the 10-day treatment course group. In addition, the researchers found that the “children in the 5-day group didn't have a lower risk of antibiotic resistance or of side effects such as diarrhea or diaper rash.”

According to Dr. Hoberman, “The results of this study clearly show that for treating ear infections in children between 9 and 23 months of age, a five-day course of antibiotic offers no benefit in terms of adverse events or antibiotic resistance. Though we should be rightly concerned about the emergence of resistance overall for this condition, the benefits of the 10-day regimen greatly outweigh the risks."