Q. My daughter’s pediatrician has always prescribed antibiotics for her ear infections, but I have read that antibiotics are not always necessary. How do I know if she really needs an antibiotic every time?
The American Academy of Pediatrics recently released updated guidelines for treating otitis media, or middle ear infections. These more stringent criteria for both diagnosis and treatment of ear infections are meant to reduce unnecessary antibiotic usage.
For parents, here are some key take-home points:
The guidelines apply to children 6 months and older without underlying medical problems.
If a child has an ear infection with severe signs or symptoms, then she should be treated with antibiotics. Severe signs or symptoms include: fever of 102.2 degrees or higher, ear pain for 48 hours or moderate to severe pain for any length of time.
Children between the ages of 6 and 23 months who have an infection in both ears should be treated with antibiotics, even if it is not severe. If the infection is in one ear, then they can just be observed closely.
Children ages 2 and older with a non-severe infection (in either one or both ears), can also wait on the antibiotics while the infection is monitored.
Non-severe otitis media is defined as having a temperature less than 102.2 degrees and mild ear pain for less than 48 hours.
If a parent chooses observation over antibiotics, the child will need a follow-up doctor’s visit in 48 to 72 hours. If the infection has not improved, antibiotics will be needed.
For more information about ear infections, visit aap.org.