Pain relief stressed for child's ears

New policy urges doctor to delay using antibiotics

March 10, 2004|By Roni Rabin | Roni Rabin,NEWSDAY

Aiming both to curb antibiotic use and to improve care, two medical associations have endorsed a new approach to common childhood ear infections, encouraging doctors to ease pain but consider postponing antibiotic treatment for two to three days.

The new treatment option could apply to many children over the age of 2 who have mild cases of acute otitis media.

Up to 80 percent of middle ear infections, though bacterial, clear up without medical intervention, studies show.

Parents could be sent home with instructions to return to the doctor, call in two to three days or be given a "safety net prescription," to be filled only if the child doesn't improve in two to three days, said Dr. Richard Rosenfeld, co-author of the new guidelines.

"In many cases, the potential harm of antibiotics exceeds the benefits for ear infections," said Rosenfeld, who is director of pediatric otolaryngology at Long Island College Hospital in Brooklyn.

"In a nutshell, the main way you make children feel better is by using a lot of pain medication: ibuprofen or acetaminophen."

The guidelines were developed by the American Academy of Pediatrics and the American Academy of Family Physicians. They were released yesterday.

Concern about the excessive use of antibiotics and the emergence of resistant strains of bacteria has been growing for some time.

Studies show that six out of 10 children with an ear infection will improve after 24 hours, whether they take antibiotics or a placebo, Rosenfeld said.

Newsday is a Tribune Publishing newspaper.

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