Antibiotics Do Not Prevent Fluid Buildup In Children's Ear Infections

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Main Category: Ear, Nose and Throat
Also Included In: Pediatrics / Children's Health;  Primary Care / General Practice;  Hearing / Deafness
Article Date: 23 Feb 2008 - 0:00 PST

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Antibiotics are not linked to a significant decrease in fluid buildup in the ear when administered to children with middle ear infections. This is the conclusion of a meta-analysis of previous studies released on February 18, 2008 in the Archives of Otolaryngology - Head & Neck Surgery, one of the JAMA/Archives journals.

In infants and children, one of the most prevalent diseases is the ear infection. Otitis media, or a middle ear infection, can lead to fluid buildup in the middle ear, developing into acute otitis media with effusion. According to the authors, this can be detrimental to development. "The effusion may lead to a conductive hearing loss of 15 decibels to 40 decibels, and this hearing loss could have an adverse effect on language development, cognitive development, behavior and quality of life."

Laura Koopman, M.Sc., of University Medical Center Utrecht, the Netherlands, and colleagues examined data taken from 1,328 children, ranging in age from 6 months to 12 years, with acute middle ear infections. All had participated in one of five randomized controlled trials comparing the use of antibiotics to a placebo or to not treatment. Approximately half were assigned not to receive antibiotic treatment.

44 percent of the children were younger than age two. Of these, 51.8 percent had repeated ear infections. In these groups, the risk of developing middle ear effusion was highest. Antibiotics reduced the risk of effusion to a statistically insignificant 90 percent of the risk without them.

The authors caution against prescription of antibiotics in these cases. "Because of a marginal effect of antibiotic therapy on the development of asymptomatic middle ear effusion and the known negative effects of prescribing antibiotics, including the development of antibiotic resistance and adverse effects, we do not recommend prescribing antibiotics to prevent middle ear effusion." Current treatment guidelines agree with this assessment, as they do not recommend prescription of antibiotics to prevent effusion.

The conclude, citing a need for further research. "However, more research is needed to identify relevant subgroups of children who have middle ear effusion that might benefit from other treatments," they conclude.

Antibiotic Therapy to Prevent the Development of Asymptomatic Middle Ear Effusion in Children With Acute Otitis Media
Laura Koopman, MSc; Arno W. Hoes, MD, PhD; Paul P. Glasziou, MD, PhD; Cees L. Appelman, MD, PhD; Peter Burke, FRCGP, MRCP(Ire); David P. McCormick, MD; Roger A. Damoiseaux, MD, PhD; Nicole Le Saux, MD, PhD; Maroeska M. Rovers, PhD
Arch Otolaryngol Head Neck Surg. 2008;134(2):128-132.
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Written by Anna Sophia McKenney
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