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If Your Ear Hurts, Take This For 10 Days Not Five

Jed Conklin

The benefits of treating ear infections with antibiotics for 10 days far outweighs any benefit associated with reducing a child’s exposure to the medication, according to researchers at Children’s Hospital of Pittsburgh.

“No question,” said Alejandro Hoberman, the hospital's division chief of general academic pediatrics. “Even more than what we expected. The five-day treatment did not work.”

Hoberman and his team launched a study of 520 children aged 9 to 23 months amid dire warnings against the over use of antibiotics. At least one study suggested shorter treatment times for ear infections might be just as good as the more standard 10-day treatment.

Hoberman found that after two weeks, children who had been treated for 10 days with amoxicillin-clavulanate got better 84 percent of the time, compared to 66 percent for the five-day treatment. His team led a similar study a few years ago, he said. They found parents could also try doing nothing; 50 percent of children became well on their own.

“There were no differences between the two treatment groups in rates of recurrence of ear infection… diarrhea, diaper rash and colonization in the back of the nose with penicillin resistant pathogens,” Hoberman said.

The study does not necessarily negate arguments over the need to reduce the use of antibiotics in general.  Hoberman said that should still be a goal, just not through shorter treatment plans.

“So in other words, it’s most important to properly diagnose ear infections, make a stringent criteria for identifying those who really need treatment, but if they need treatment, treat them with the appropriate antibiotic for the right duration of time.”

The study, published Wednesday in the New England Journal of Medicine, is hugely important for parents, he said. Research shows three out of four children will get an ear infection before their first birthday, and those infections are the most common cause for pediatric antibiotic prescriptions.

“This hopefully settled this question for good,” Hoberman said.

His team is also studying the best course of treatment for pediatric urinary tract infections and community-acquired pneumonia.