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Home › Articles › Illnesses, Diseases & Disorders › Avoiding Antibiotics

Avoiding Antibiotics

New Guidelines for Ear Infections

By Kelly Burgess

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factors that contribute to ear infections are secondhand smoke, not feeding baby in an upright position, pacifiers and poor infection control.

Dr. Brown is familiar with the new guidelines. She has coined the phrase "The Denmark Plan," because this monitoring approach is a common one in the Dutch community. "This is a reasonable approach to ear infections, but I understand why it will be a hard sell," says Dr. Brown. "A lot of parents work outside the home and if you tell them to just watch their child's symptoms and come back in a couple of days, they have to miss another day of work, as well as pay for another office visit. Also, if you have a child who's really not getting better you may not be sleeping. But those are the downsides we have to face for the long-term health of our children."

What Dr. Brown recommends, and Dr. Rosenfeld heartily agrees with, is to treat the pain with analgesics, such as ibuprofen or acetaminophen. It's also important to be consistent about giving the pain medication on a regular time schedule to help control the symptoms. She also suggests that perhaps a warm compress on the ear or elevating the head of the bed may help as well.

"The fact is that without antibiotics about 80 percent of patients with ear infections get better on their own," says Dr. Rosenfeld. "With the antibiotics it goes up to about 90 percent, which is better but not so much better that it makes it worth the possible consequences of over prescribing."

While the AAP is still grappling with the issue of how to make these guidelines understood by busy parents across America, a good guideline for now is to take your child to the pediatrician if he's sick, but be more active in questioning that ear infection diagnosis

Child Age Certain Diagnosis Uncertain Diagnosis
Under 6 months Antibiotics Antibiotics
6 months to 2 years Antibiotics Antibiotics if severe illness.
Observe if non-severe illness.
2 years or older Antibiotics if severe illness.
Observe if non-severe illness.		 Observe

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