Latest On Ear Infections And Amoxicillin - More May Be Best
By Rita Rubin
Despite the emergence of drug-resistant bacteria strains, the old standby antibiotic amoxicillin is still the best first-line treatment for children's ear infections - but doctors should double the standard dose, says a report out Monday.
Over the past five years, the growing problem of antibiotic-resistant Streptococcus pneumoniae " the cause of 40% to 50% of cases of symptomatic ear infections, or acute otitis media " has raised concerns about the effectiveness of amoxicillin. So the Centers for Disease Control and Prevention convened a working group to hammer out treatment recommendations.
Doubling the standard dose would increase the drug's effectiveness, and amoxicillin is still safe at that level, the group concludes in its report in the January issue of the Pediatric Infectious Diseases Journal.
"If your child is treated for otitis media and (is) not better in three to five days, your child should be re-evaluated," says lead author Scott Dowell, a medical epidemiologist at the CDC's Respiratory Diseases Branch.
At that point, an alternative drug may by needed, the working group advises. The three best choices: oral amoxicillin-clavulanate, a combination that minimizes resistance to amoxicillin; oral cefuroxime axetil; and injectable ceftriaxone. None of them is effective against all strains of bacteria that can cause ear infections, Dowell notes.
Drug resistance has become a major problem in this country because of antibiotic misuse, he says, and overtreatment of ear infections has been a big contributor.
About a third of ear infections are asymptomatic and happen to get diagnosed during well-baby checkups, Dowell says.
"One of the important steps in using antibiotics more wisely is not to treat those kids."