Reducing the Duration of Antibiotics Does More Harm than Good When Treating Ear Infections in Young Children
In a landmark trial conducted at Children’s Hospital of Pittsburgh of UPMC and the University of Pittsburgh School of Medicine, researchers have demonstrated that when treating children between 9 and 23 months of age with antibiotics for ear infections, a shortened course has worse clinical outcomes without reducing the risk of antibiotic resistance or adverse events.
The results of the trial are published in the New England Journal of Medicine and highlighted by an accompanying commentary.
“Given significant concerns regarding overuse of antibiotics and increased antibiotic resistance, we conducted this trial to see if reducing the duration of antibiotic treatment would be equally effective along with decreased antibiotic resistance and fewer adverse reactions,” said Alejandro Hoberman, M.D., chief, Division of General Academic Pediatrics at Children’s, and the Jack L. Paradise Endowed Professor of Pediatric Research at Pitt’s School of Medicine.
“The results of this study clearly show that for treating ear infections in children between 9 and 23 months of age, a 5-day course of antibiotic offers no benefit in terms of adverse events or antibiotic resistance. Though we should be rightly concerned about the emergence of resistance overall for this condition, the benefits of the 10-day regimen greatly outweigh the risks,” said Dr. Hoberman.
Source & further reading:
http://www.upmc.com/media/NewsReleases/2016/Pages/nejm-paper.aspx
Paper:
http://www.nejm.org/doi/full/10.1056/NEJMoa1606043
#research #antibiotics #otitis #babies #science #medicine #health
My recollection is that this is precisely what would be expected: antibiotic resistance comes from short courses of antibiotics, that don't manage to kill all the targets but leave the ones most resistant to the antibiotics alive. It's good research, but the result seems to be presented as if it's a surprise, when I would have thought it confirmed what anyone involved with this would anticipate.
ReplyDeleteVarious studies have looked into this, showing that antibiotics, when averaged out over hundreds of cases, generally reduce the overall duration and severity of middle ear infections a little. In reality, on an individual case by case basis, some entirely viral cases will not benefit at all, while others with bacterial infection will benefit from antibiotics.
ReplyDeleteIt is difficult to know whether each infection is mainly viral or bacterial. Higher temperatures (more than 39°C) and a sicker child generally suggest bacterial infection, but this is not always the case.
So, your child is sick...you visit the dr. and after a 5 day treatment with antibiotics when the child starts to feel better...you wonder if is ok to wear Dr.'s pants and simply decide to stop the treatment. After all, what a heck, the child is feeling good. Therefore, the surprise and study is mainly for these people.