'The bread and butter of pediatrics' is declining

If you are a pediatrician or a parent, you may have noticed a decline in ear infections.

Perri Klass, MD — who is both a pediatrician and a parent — certainly has. Writing for The New York Times, she said she first noticed the decline when a pediatrician refused to diagnose her youngest child with an ear infection. It was comforting to her that the physician did not rush to prescribe antibiotics, when upon further inspection her child simply had an upper respiratory infection.

"When I started practicing pediatrics in the 1990s, it seemed we diagnosed a case of otitis media — middle ear infection — every few minutes. I knew the antibiotic dosages by heart for children of every weight," Dr. Klass wrote. She cited studies published in January 2014 and March 2016 that demonstrate significant decline in ear infection diagnoses over the past few decades. But why has otitis media — what Dr. Klass calls "once the very definition of 'bread and butter pediatrics'" — become more rare?

In large part it is a combination of good parental decision making: Routine vaccinations against Streptococcus pneumoniae and influenza, breast-feeding and less parental smoking are all actions that can lower ear infection risk in children, according to Dr. Klass.

On the part of physicians though is a notable increase in vigilance surrounding the overprescription of antibiotics. "It's a happy pediatric story of the convergence of improved preventive measures, healthier environments for young babies and the medical profession's trying to be scrupulous about limiting interventions," Dr. Klass wrote.  


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