Seeing eye to eye on ear infections

By Lauren Edwards • Published: May 13th, 2008
Category: Health in a Heartbeat

Your baby is screaming, and you think he might have an ear infection. Wanting to relieve his symptoms, you rush him to the doctor. Good idea? Maybe not. Doctors frequently overdiagnose, or at least overtreat, ear infections.

The American Academy of Pediatrics and the American Academy of Family Physicians set guidelines on when to treat a suspected ear infection with antibiotics and when to wait it out. But a recent survey found that although eighty-three percent of physicians found waiting to be a sensible approach, they did this just fifteen percent of the time. Why?

It’s difficult to diagnose children whose ear canals are small and blocked by wax. Babies can’t explain symptoms, and doctors have to decide if pain is caused by infection or something else. Fluid buildup in the ear… called otitis media [oh-tie-tiss mee-dee-ah] with effusion… can occur. Although it’s not an infection, O-M-E can indicate a prior or oncoming infection, making an accurate diagnosis tough.

While eighty to ninety percent of ear infections clear on their own, antibiotics can expedite this process, yet shouldn’t be given unnecessarily. What to do? Guidelines say children under six months should receive antibiotics, as should children six months to two years whose diagnosis of infection has been confirmed or who have severe pain or fever over one-hundred-two degrees. For older children, a confirmed diagnosis and severe pain warrant antibiotics, as well.

If your child doesn’t fall into one of these categories, it may be best to wait it out.