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By Dr. Sue Hubbard

The American Academy of Pediatrics just released new guidelines for the diagnosis and treatment of acute otitis media, which is “doctor speak” for an ear infection.

An ear infection is one of the most common maladies of early childhood and also one of the most common reasons antibiotics are prescribed. Guidelines from 2004 recommended that pediatricians use “watchful waiting” before prescribing antibiotics for an ear infection in some children.

The new guidelines for treating ear infections with oral antibiotics are even more specific than those issued in 2004, and further clarify which are the best children to observe and those that should be treated right away. This will reduce the number of unnecessary antibiotics that are prescribed, which in turn may help prevent antibiotic-resistant bacteria.

According to the new guidelines, children need to receive immediate antibiotics if they have a severe ear infection (with a fever of 102.2 degrees or higher, or significant pain), have a ruptured ear drum with drainage, or an ear infection in both ears in a child age 2 or under.

As both pediatricians and parents know, all sorts of things that cause ear pain, from an erupting new molar to a cold or sore throat. But if the eardrum is not bulging, the best treatment is pain control with acetaminophen or ibuprofen and watchful waiting to see if a child’s symptoms worsen or if the pain resolves. In studies, two out of three children get better without an antibiotic.