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Researchers call for caution on antibiotics for infant ear infections

By Ashleigh Goff

Young children who are given antibiotics to treat acute ear infections are 20% more likely to suffer from recurrent ear infections than children given a placebo, according to Dutch trial research published online in the BMJ today.

The trial, conducted across 53 general practices in the Netherlands, included 168 children aged six months to two years of age and found 63% of children given amoxicillin for acute ear infections had a recurrence of the infection within three years, compared to a 43% rate of recurrence in children given a placebo.

However, 30% of children in the placebo group had to undergo ear, nose, and throat surgery on initial infection, compared with only 21% in the amoxicillin group which researchers said may have affected the results.

Current guidelines recommend prescribing antibiotics to children with severe illness and in those younger than two years of age with severe infection, but research shows this might not be the best option.

The researchers suggested that the difference in recurrence rates between the two groups could be due antibiotic use that may cause an ‘unfavourable shift' towards the growth of resistant bacteria, which in turn causes a weakening of the children's natural immune response system.

Study author Dr Roger Damoiseaux a GP in Hattem the Netherlands, told Pulse: ‘These facts should make us cautious to change guidelines for acute otitis media on the basis of these findings alone. In the Netherlands the guidelines for acute otitis media are more restrictive compared with other countries.

‘We advise giving antibiotics for children less than 6 months old, children with risk factors for an extended course and children who are very ill at presentation. This research certainly adds some proof against an abundant use of antibiotics in young children.'

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