Ear Infections: Why Kids May Not Need 10 Days of Antibiotics

Imagine for a moment that you’ve been up all night (three nights in a row) with your sick kindergartener. For some of us, this is not hard to imagine! He has been holding his right ear and crying in pain. You’ve been through this before, and you suspect he has another ear infection. After his pediatrician examines him and confirms your suspicion, you head to the pharmacy to pick up the antibiotic that will help his body fight the bacterial ear infection. But wait - you know that you are sleep-deprived, but when you look at the medication instructions, it says to take the medicine for only seven days. In the past, he’s always had antibiotics for TEN days… and isn’t it bad not to take a full round of antibiotics?

Let’s Review the Current Guideline.

The American Academy of Pediatrics (AAP) updated their recommendations for treating childhood ear infections in 2013. The current guideline, based on clinical studies and expert opinion, states that a full ten days of antibiotics may not be necessary for children over two years of age with non-severe ear infections. For these kids, five to seven days of antibiotics may be enough. However, children over two years of age with a severe ear infection (fever greater than 102 degrees Fahrenheit or those with severe ear pain) and kids with another bacterial infection at the same time as the ear infection (like pneumonia or strep throat) may still require the full ten days of antibiotics.

While antibiotics are great for fighting certain infections, they can also kill your body’s normal, “good” bacteria and contribute to the development of resistant bacteria, which means a particular antibiotic is less likely to work the next time you need it. Antibiotics may cause side effects and increase the cost of fighting an infection. When an antibiotic is given for a shorter duration, your child is less likely to experience these negative effects.

But Will It Still Work?

In most cases, yes! That’s why the guidelines for treating ear infections changed in 2013. However, each child’s situation is unique, and your family’s medical provider is the best person to decide how long your child should take an antibiotic for an ear infection. On the other hand, if your child is over the age of two and has a non-severe ear infection, it makes sense to ask your provider about the possibility of a shorter course of treatment.

As always, talk to your doctor if you have other questions or concerns, and always follow the directions on your child’s medication.

You can read the full AAP clinical practice guideline for treating ear infections here.

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