Shortened antibiotics course for children with ear infections does more harm than good

A study published Wednesday in the New England Journal of Medicine demonstrated when treating children between 9 months and 23 months of age for an ear infection, the shortened course of antibiotics leads to worse clinical outcomes and does not reduce the risk of antibiotic resistance.

Acute otitis media, or a bacterial infection of the middle ear, is the most common reason children are prescribed antibiotics, as three out of four children get such an infection before they turn 1 year old.

"Giving significant concerns regarding overuse of antibiotics and increased antibiotic resistance, we conducted this trial to see if reducing the duration of antibiotic treatment would be equally effective along with decreased antibiotic resistance and fewer adverse reactions," said Alejandro Hoberman, MD, a pediatrician at Children's Hospital of Pittsburgh of UPMC.

Dr. Hoberman and his team randomly assigned 520 children with an ear infection to either a standard 10-day dose of amoxicillin-clavulanate or a five-day treatment with five additional days of placebo.

They found the five-day dose had a 34 percent risk of treatment failure, while the 10-day treatment group had only a 16 percent risk of failure. Additionally, there was no decrease in the presence of antibiotic-resistant bacteria in the five-day group.

Dr. Hoberman and the team concluded the benefits of the 10-day antibiotic regimen "greatly outweigh the risks," he said.

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