Delay of ear infection therapy avoids drug overuse

Telling parents to wait 48 hours before filling a prescription for antibiotics, so they can see if their child’s ear infection clears up on its own, can help reduce the overuse of these drugs and consequently lower rates of drug resistance, researchers said on Tuesday.

U.S. doctors write 15 million antibiotic prescriptions a year for children’s ear infections, though there is increasing evidence the drugs may not be necessary. Excessive antibiotic use could lead to the development of antibiotic-resistant bacteria and cause drug reactions such as vomiting and diarrhea.

By taking a “wait-and-see” approach where the parent is given a prescription but told to wait 48 hours to fill it, researchers at Yale University in New Haven, Connecticut, found fewer prescriptions were filled.

Out of 238 patients aged 6 months to 12 years brought to a hospital emergency room complaining of ear infections, two-thirds of the parents who were told to wait ultimately did not fill their prescriptions.

Children who did not have prescriptions filled for them recovered at the same rate as those whose prescriptions were filled right away, an indication the condition often clears up on its own.

Those in the wait-and-see group who did obtain the drugs did so because their children developed a fever, an earache or fussy behavior.

All the children were given ibuprofen and analgesic drops.

“Parents should be empowered to make a decision at 48 hours whether to fill or not fill an antibiotic prescription and this strategy could significantly reduce antibiotic use in the United States,” said Dr. David Spiro, who has since moved to Oregon Health and Science University, in Portland.

“Our study found that empowering parents to do this is a safe and effective strategy,” he added.

An editorial accompanying the study in the Journal of the American Medical Association said seriously ill children and those with systemic problems are unlikely candidates for delayed prescribing.

Print Version
Tell-a-Friend