2004 AAP Guidelines for Treating Ear Infections

Every year, millions of children suffer from painful ear infections. Parents look to their child's doctor for help in easing the pain. The American Academy of Pediatrics and the American Academy of Family Physicians have released new guidelines to help parents and physicians decide on the best treatment for acute otitis media (AOM), or middle ear infection.

AOM is the most common bacterial illness in children and the one most commonly treated with antibiotics. Allan Lieberthal, MD, FAAP, co-chair of the guideline panel, states, "Accurate diagnosis of AOM is the key to this guideline. We need to make sure that the child has AOM before prescribing an antibiotic. If a child is given an antibiotic and doesn't need it, he or she may build up an antibiotic resistance and not respond to them when needed for a more serious infection, such as pneumonia or meningitis." The guidelines stress that about 8 in 10 children with ear infections get better with no antibiotics at all.

According to Ted Ganiats, MD, a family physician in San Diego, CA, and co-chair of the guideline panel, the most important step to take in the case of any ear infection is to relieve the child's pain. "We want parents and doctors to first make the child comfortable with pain relievers such as ibuprofen and acetaminophen. Antibiotics do not relieve pain during the first 24 hours and do not reduce fever any quicker or better than pain medicines," he said.

Antibiotics may be the right choice for children up to the age of two who have ear infections and not just fluid in their ears. They may also be appropriate if a child is very sick or has a high fever. The guideline recommends observing select children and starting antibiotic treatment only if symptoms have not improved in 48 to 72 hours. The guideline also notes that 80 percent of children whose ear infections are not treated immediately with antibiotics get better on their own and have no increased risk of a serious infection.

Page Two: Find out what the new guidelines recommend

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