Pediatric Academy weighs in on children s ear infections: Just watch em

In an effort to reduce unnecessary antibiotic use, this morning the American Academy of Pediatrics issued new guidelines for how doctors should diagnose and treat ear infections.

The guidelines, which appear in the March issue of Pediatrics, attempt to clarify the signs and symptoms that indicate an infection that might need treatment. They also encourage observation with close follow-up instead of antibiotic treatment for many children. About 70 percent of children get better on their own within two or three days, and about 80 percent are better within a week to 10 days, says Dr. Richard Rosenfeld of the State University of New York Downstate Medical Center, who helped write the new guidelines.

He says there are some real downsides to using antibiotics when they're not necessary: They can cause upset stomachs, allergic reactions and other problems. And they can contribute to the development of superbugs infections that are getting harder and harder to cure.

The guidelines also address children with recurrent infections, advising physicians and parents when it's time to see a specialist.

ACSH s Dr. Gilbert Ross was taken aback at the disconnect between the academics responsible for such recommendations, and clinicians on the ground caring for sick children and dealing with their parents. As both a father and a former clinician although I rarely dealt with kids I have a big problem imagining watchful observation of a toddler or youngster with an ear infection over the course of a week to 10 days. That is just not going to happen in the real world. I d like to see the AAP experts watch their own kids suffering with otitis for that long without any intervention.