Ear Infections: New Thinking on What to Do

Jan. 4 -- SATURDAY, Jan. 2 (HealthDay News) -- Parents who've ever suspected their youngster had an ear infection might have been inclined to call the doctor, schedule a visit and expect an antibiotics prescription.

That's been the ritual. But no more.

"Until eight or nine years ago, we'd treat each ear infection at diagnosis," said Dr. David Tunkel, director of pediatric otolaryngology at Johns Hopkins School of Medicine and chairman of the pediatrics committee for the American Academy of Otolaryngology.

"The thought was, you would reduce the symptoms quicker," Tunkel said. "Then it became clear that many children who weren't treated with antibiotics actually did well without the initial treatment."

As a result, Tunkel said, guidelines issued in 2004 by the American Academy of Pediatrics and the American Academy of Otolaryngology began to encourage what doctors call an "observation option." That means that children 2 years and older who are otherwise healthy can be observed for a short period of time before being given antibiotics.

Ear infections are the most common illness among infants and young children, according to the U.S. National Institutes of Health, with an estimated three of every four kids having an ear infection before age 4. Usually infection occurs in the middle ear and is called otitis media. It's called otitis media with effusion when fluid and mucus build up in the tubes of the middle ear.

Ear infections often clear up on their own. But another pediatric otolaryngologist, Dr. Richard Rosenfeld, stressed that "observation is different than no treatment." Rosenfeld is chairman of otolaryngology at Long Island College Hospital and the State University of New York Downstate Medical Center and a consultant for the American Academy of Pediatrics on the ear infection guidelines.

When recommending observation before medication, he said, doctors might send parents home with a "safety net" prescription, one to have on hand in case the situation worsens. Parents should ask the doctor for specifics on the timeline for observation, which typically ranges from one to three days.