Antibiotics for an ear infection lead to... more ear infections

In a survey done nearly 10 years ago, half of all pediatricians said they were regularly pressured by children's parents to prescribe unnecessary antibiotics. What's more, a third said they sometimes caved, writing scripts simply because of parental demands.

It would be interesting to know if things have changed. Doubtless parents still want the best for their children, but there's been plenty of publicity about dangerous, hard-to-treat infections caused by antibiotic-resistant bacteria, and how these dangerous strains are created partly by overuse of antibiotics.

There have also been many attempts to explain to the public that antibiotics are often of limited use for everyday illnesses, have side effects, and contribute to the wider problem of treatment-resistant infections.

New research published in the BMJ gives even more reasons to be cautious about giving antibiotics to children. In the study, 168 children had been randomly given antibiotics or a placebo for an ear infection. Three years later, the researchers asked the children's parents how many more ear infections the children had suffered.

If children had taken antibiotics, there was a 63 percent chance they'd had at least one subsequent infection. The risk was only 43 percent for children who'd been given an inactive placebo.

The researchers think that antibiotics might kill off some of the weaker bacteria causing a child's infection, leaving more space for tougher, antibiotic-resistant bacteria to grow. Another theory is that killing bacteria with antibiotics means less work for a child's immune system, leading to weaker protection from infections in future.

We do know that antibiotics help ear infections clear up slightly more quickly, but for an illness that almost always goes away without treatment, it's reasonable to weigh the benefits against the risks. As a compromise, doctors sometimes write a script for antibiotics and suggest parents wait a few days before using it. That way, if your child gets better, you don't have to use treatment. If your child gets worse, you can pick up the antibiotics without needing to see your doctor again.

What you need to know. Ear infections affect almost all children at some point. Simple painkillers, such as acetaminophen, are the standard treatment. For children under 2 or children with more serious infections, doctors often recommend antibiotics.

—Philip Wilson, patient editor, BMJ Group

ConsumerReportsHealth.org has partnered with The BMJ Group to monitor the latest medical research and assess the evidence to help you decide which news you should use.

Find out how to keep your child from getting ear infections and what questions to ask your doctor about your child's ear infection. And for a comparison of painkillers and antibiotics to treat ear infections, see our Treatment Ratings (subscribers only).