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Waiting a few days to see whether symptoms of an ear infection
improve before beginning a course of antibiotics appears to be a
practical way to reduce the use of antibiotics. This may
help prevent the overuse of the drugs, and thus prevent bacteria
from becoming resistant.
And even though physicians often complain that parents pressure
them to prescribe antibiotics, most parents in the study
were satisfied with a "wait-and-see"
approach for treating the common ear infection otitis media.
A wait-and-see approach in the management of acute otitis media
is feasible and was acceptable to most parents, and resulted in
a 76% reduction in the use of antibiotic
prescriptions.
Each year millions of children are prescribed antibiotics to treat
the middle ear infection, but the evidence that the drugs speed
a child's recovery is mixed. Plus, antibiotics can cause side
effects such as diarrhea, and widespread prescription of the
drugs is thought to be increasing the risk that bacteria will become
resistant to antibiotics.
The study showed there was no significant difference in the reduction
of pain or distress in children given antibiotics versus those who
were not.
Parents of children who were treated immediately were more likely
to believe in the effectiveness of antibiotics for otitis media,
even though the infection can clear up on its own. This may encourage
repeat visits for future ear infections, leading to even more antibiotic
prescriptions, according to the authors.
While it is difficult to fault parents who want to seek treatment
for a child in pain, parents can help a
child without resorting to antibiotics, the authors note.
British Medical Journal February
10, 2001; 322: 336-342
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