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Antibiotic Use for Otitis Media Should Be Limited

Curbing antibiotics for more than half of otitis media cases could reduce antibiotic-resistance risks

FRIDAY, Oct. 20 (HealthDay News) -- Antibiotics for otitis media seem the most beneficial for patients under age 2 who have bilateral infections or children of any age who also have otorrhea, researchers report in the Oct. 21 issue of The Lancet. Other children, which make up more than half of all such patients, could be treated with watchful waiting, a strategy that could cut down on drug-resistant bacteria.

Maroeska M. Rovers, Ph.D., of the University Medical Center in Utrecht, the Netherlands, and colleagues conducted a meta-analysis of six studies, which included 1,643 children aged 6 months to 12 years old. The endpoint was continued pain or fever at three to seven days.

The researchers estimate that four children under age 2 with bilateral infections would need to be treated (number-needed-to-treat) with antibiotics to prevent one case of extended pain and fever. The number-needed-to-treat was 20 for children under age 2 with unilateral infections, nine for children aged 2 or over with bilateral infections, 15 for older children with infection in one ear, and three for children of any age with otorrhea.

In an editorial, Petri S. Mattila, M.D., of Helsinki University Central Hospital in Finland, points out that limiting antibiotics in pediatric otitis would cut medical costs and resistance risks, but "watchful waiting with pain relief must include the exclusion of other bacterial infections, with proper parental education and easy access to follow-up care."

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