Antibiotics of Limited Benefit in Pediatric Acute Otitis Media
When we look at the side effects of antibiotics, we typically only look at immediate effects such as rashes or diarrhea. Very rarely do we look at the fact that much of the normal flora is destroyed in the process and the long term health effects can be quite damaging. So, not only do we have potentially very damaging long term effects, immediate side effects, increased cost AND the development of antibiotic resistance…but antibiotics are not much more effective than placebo!!!
Over 80% of children with acute otitis media improve without antibiotic therapy within a week. That compares with 93% recovery during the first week with antibiotic treatment, according to a study released by the Agency for Healthcare research and Quality (AHRQ). The study also found that children treated with amoxicillin had similar outcomes to those treated with more expensive antibiotics such as cefaclor, azithromycin and clarithromycin. The authors recommend that further research look into “watchful waiting” as standard practice in the management of acute otitis media. The practice is common in the Netherlands, where antibiotic resistance runs as low as 1%, compared to as high as 25% in the United States. It is estimated that 5 million episodes of otitis media occur each year in the United States at a total cost of $3 billion.