Parents out there, I have something for you to read about ear infections and antibiotics. It's an easy read, but it is a bit long. Nonetheless, I think every parent should read it.
80% of all ear infections clear up on their own. Back in 2004, new guidelines were given to doctors regarding the treatment of ear infections. The article below lists the guidelines. I think it's important to be familiar with them.
Despite these new guidelines, American doctors still over prescribe antibiotics for ear infections, at alarming rates.
Why?
I believe they want and need parents to like them, in order to have a thriving practice. If they follow conservative guidelines, they risk gaining a reputation for rarely giving out antibiotics, and consequently, too many parents would avoid their practice. When babies and toddlers are screaming in the night and waking frequently, parents want answers and treatment, usually in the form of antibiotics. Doctors feel compelled to acquiesce. Also, it would take too long to explain why a prescription isn't needed. Time is money.
Today Peter went to the doctor for a routine ADHD check up, to obtain another prescription for his Strattera. The doctor always gives him a complete physical exam at these appointments. He looked in Peter's ears and found infection in the right one. I said that Peter was three days into a mild cold. Doc asked Peter if there was any pain, and Peter said no. Doctor was surprised at that.
He wrote a prescription anyway!
I am not going to fill the prescription, unless Peter develops severe symptoms after three days. If he remains symptomless, I will have his ear rechecked at his next ADHD check up, in two months.
I learned that children over 4 tend to get asymptomatic ear infections--no pain or fussiness or fever. Often it isn't known that an infection is present until a child fails a school hearing test, due to fluid behind the eardrum.
Last December I took Paul, my seven year old, in for a flu shot. Doctor checked him over first and found an ear infection, which either started because of allergies, or from a cold in late November, or both. Again, there was no pain or symptoms. Doctor wrote a prescription, and I filled it. I had little experience with ear infections. My kids aren't prone to them, so I never had to do any homework.
In January I took Paul for his yearly check-up, and to get the flu shot he couldn't get in December, due to being put on antibiotics. Clear fluid was present--not infected. The doctor put him on the same antibiotic, saying it would probably clear up the fluid. My husband and I were scratching our heads. With no infection present, why another round of drugs?
However, we filled it, because the doctor explained that Paul would have to get ear tubes if the fluid did not clear up by three to four months from onset. It had been nearly two months since the initial infection. We figured the doctor must have reason for believing that antibiotics would clear up fluid. We wanted to avoid surgery at all costs.
Well, we went back in March to have the fluid checked. It was still there! Clear, not infected. Paul had failed a hearing test at his yearly check-up (Jan), and again in March at this appointment, due to the fluid. The doctor gave us a referral to an ENT. The appointment is in late April. I plan to fight the use of tubes, based on my research, especially if the fluid is still clear and not gel like. The hearing difficulty is not an issue in terms of Paul's learning, and I feel the fluid will drain on its own when the weather is warmer. Fluid tends to hang around longer in the winter months.
They now know that even in very young children, the tubes don't improve speech and language development, as was thought for many years. They also don't decrease the number of infections, necessarily. Ear tubes, like antibiotics, are overused in America. Having them put in causes scarring, which is a factor in long-term hearing loss in kids who need them more than once.
It is true that chronic ear infections can also cause scarring, but ear infections tend to become chronic when antibiotics are overused! Ear infections treated with pain relief, and no antibiotics, clear up with fewer complications than those treated with antibiotics.
And studies show that treating with antibiotics only decreases pain by one day, compared to not treating with antibiotics.
I feel angry that I wasn't given better information. I wouldn't have filled any prescriptions, had I known these guidelines, given by the AAP back in 2004! The information is still current today.
Doctors: Skip Antibiotics for Child Ear Infections - shorter article
Dr.Greene.com - Antibiotics and Ear Infections - new guidelines
80% of all ear infections clear up on their own. Back in 2004, new guidelines were given to doctors regarding the treatment of ear infections. The article below lists the guidelines. I think it's important to be familiar with them.
Despite these new guidelines, American doctors still over prescribe antibiotics for ear infections, at alarming rates.
Why?
I believe they want and need parents to like them, in order to have a thriving practice. If they follow conservative guidelines, they risk gaining a reputation for rarely giving out antibiotics, and consequently, too many parents would avoid their practice. When babies and toddlers are screaming in the night and waking frequently, parents want answers and treatment, usually in the form of antibiotics. Doctors feel compelled to acquiesce. Also, it would take too long to explain why a prescription isn't needed. Time is money.
Today Peter went to the doctor for a routine ADHD check up, to obtain another prescription for his Strattera. The doctor always gives him a complete physical exam at these appointments. He looked in Peter's ears and found infection in the right one. I said that Peter was three days into a mild cold. Doc asked Peter if there was any pain, and Peter said no. Doctor was surprised at that.
He wrote a prescription anyway!
I am not going to fill the prescription, unless Peter develops severe symptoms after three days. If he remains symptomless, I will have his ear rechecked at his next ADHD check up, in two months.
I learned that children over 4 tend to get asymptomatic ear infections--no pain or fussiness or fever. Often it isn't known that an infection is present until a child fails a school hearing test, due to fluid behind the eardrum.
Last December I took Paul, my seven year old, in for a flu shot. Doctor checked him over first and found an ear infection, which either started because of allergies, or from a cold in late November, or both. Again, there was no pain or symptoms. Doctor wrote a prescription, and I filled it. I had little experience with ear infections. My kids aren't prone to them, so I never had to do any homework.
In January I took Paul for his yearly check-up, and to get the flu shot he couldn't get in December, due to being put on antibiotics. Clear fluid was present--not infected. The doctor put him on the same antibiotic, saying it would probably clear up the fluid. My husband and I were scratching our heads. With no infection present, why another round of drugs?
However, we filled it, because the doctor explained that Paul would have to get ear tubes if the fluid did not clear up by three to four months from onset. It had been nearly two months since the initial infection. We figured the doctor must have reason for believing that antibiotics would clear up fluid. We wanted to avoid surgery at all costs.
Well, we went back in March to have the fluid checked. It was still there! Clear, not infected. Paul had failed a hearing test at his yearly check-up (Jan), and again in March at this appointment, due to the fluid. The doctor gave us a referral to an ENT. The appointment is in late April. I plan to fight the use of tubes, based on my research, especially if the fluid is still clear and not gel like. The hearing difficulty is not an issue in terms of Paul's learning, and I feel the fluid will drain on its own when the weather is warmer. Fluid tends to hang around longer in the winter months.
They now know that even in very young children, the tubes don't improve speech and language development, as was thought for many years. They also don't decrease the number of infections, necessarily. Ear tubes, like antibiotics, are overused in America. Having them put in causes scarring, which is a factor in long-term hearing loss in kids who need them more than once.
It is true that chronic ear infections can also cause scarring, but ear infections tend to become chronic when antibiotics are overused! Ear infections treated with pain relief, and no antibiotics, clear up with fewer complications than those treated with antibiotics.
And studies show that treating with antibiotics only decreases pain by one day, compared to not treating with antibiotics.
I feel angry that I wasn't given better information. I wouldn't have filled any prescriptions, had I known these guidelines, given by the AAP back in 2004! The information is still current today.
Doctors: Skip Antibiotics for Child Ear Infections - shorter article
Dr.Greene.com - Antibiotics and Ear Infections - new guidelines
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