Treating ear infections in very young children with antibiotics increases the risk of recurrence within 2.5 years. This has been concluded by researchers from University Medical Center (UMC) Utrecht in the paper published by the British Medical Journal on July 1, 2009. They argue in favor of judicious use of antibiotics in children with ear infections.
A total of 168 children with inner ear infections – also known as acute otitis media – were treated with the antibiotic amoxycillin or with a placebo. After 2.5 years, the researchers analyzed the health of the children following the ear infection through a questionnaire given to the parents. It appeared that children who had been treated with the antibiotic had a twenty percent higher chance of recurrent ear infection compared to the others. The infection recurred in 47 out of the 75 children (63 percent) in the antibiotic group and in only 37 out of the 86 children (43 percent) in the placebo group. Incidentally, more children in the placebo group had ear, nose, and throat surgery compared with the antibiotic group.
This is the first time that the long-term effects of antibiotic use in young children have been investigated in such a trial. Maroeska Rovers, an epidemiologist at the Julius Center for Health Sciences and Primary Care of University Medical Center (UMC) Utrecht led this research. “These results mean that we have to be careful using antibiotics to treat children with an ear infection. It is possible that antibiotics influence the immune system and therefore make the children more susceptible to recurrent infections. Moreover, the unnecessary use of antibiotics can lead to resistance, which makes future infections more difficult to treat.”
An acute otitis media is one of the most commonly occurring infections in young children. It is also the most significant cause of antibiotic use in this group of children. The current guideline from the Dutch College of General Practitioners (NHG) recommends the use of antibiotics in only a select group of children under the age of 2 years. Moreover, a wait-and-see policy for children over the age of 2 years should be applied.
The study was conducted in 53 general practices in the Netherlands. The children were between the ages of six months to two years at the start of the study.