- Despite the emergence of drug-resistant bacteria strains,
the old standby antibiotic amoxicillin is still the best first-line treatment
for children's ear infections - but doctors should double the standard
dose, says a report out Monday.
- Over the past five years, the growing problem of antibiotic-resistant
Streptococcus pneumoniae " the cause of 40% to 50% of cases of symptomatic
ear infections, or acute otitis media " has raised concerns about
the effectiveness of amoxicillin. So the Centers for Disease Control and
Prevention convened a working group to hammer out treatment recommendations.
- Doubling the standard dose would increase the drug's
effectiveness, and amoxicillin is still safe at that level, the group concludes
in its report in the January issue of the Pediatric Infectious Diseases
- "If your child is treated for otitis media and (is)
not better in three to five days, your child should be re-evaluated,"
says lead author Scott Dowell, a medical epidemiologist at the CDC's Respiratory
- At that point, an alternative drug may by needed, the
working group advises. The three best choices: oral amoxicillin-clavulanate,
a combination that minimizes resistance to amoxicillin; oral cefuroxime
axetil; and injectable ceftriaxone. None of them is effective against all
strains of bacteria that can cause ear infections, Dowell notes.
- Drug resistance has become a major problem in this country
because of antibiotic misuse, he says, and overtreatment of ear infections
has been a big contributor.
- About a third of ear infections are asymptomatic and
happen to get diagnosed during well-baby checkups, Dowell says.
- "One of the important steps in using antibiotics
more wisely is not to treat those kids."