Antibiotics no longer first choice for fighting ear infections

Canadian doctors are re-thinking when they should prescribe antibiotics for ear infections in children.

Julie Renaud's three children have all gone through rounds of antibiotics. When they go to their doctor in Windsor, they get drugs.

"When you wait in the waiting room for one to two hours because your kid has been up for three nights pulling at his ear ... you want some relief," said Renaud, adding that for her kids antibiotics seemed to do the trick.

But growing resistance to antibiotics from overuse and a better understanding of ear infection are driving doctors to change how they treat the pain.

• FROM APRIL 30, 2001: Ear drops, antibiotics equally effective for kids' ear infections: study

In the U.S., new guidelines say most children over two just need to take a painkiller and then wait and see if the infection clears by itself.

The new Canadian guidelines are expected this fall.

Doctors in Edmonton, however, changed their approach 2 years ago. The local health authority launched a campaign to reduce the use of antibiotics in children.

"Children no longer respond to antibiotics that used to work, so you can see the nightmare scenario," said Dr. Terry Klassen of Stollery Children's Hospital. "Let this happen over the next 20, 30 years and you could have a case of infection that could be treated with no antibiotic known to humans."

To add to the problem, the pharmaceutical industry is developing fewer antibiotics. High development costs and short-term use make antibiotics less profitable than blockbuster drugs for chronic conditions.

With so-called superbugs becoming resistant to existing medications, the Canadian Pediatric Society wants to cut down on antibiotic use everywhere.

• FROM FEB. 6, 2002: New vaccine combats childhood diseases

The childhood earaches are targeted because most ear infections are caused by viruses, not bacteria, and antibiotics don't work against viruses.

Dr. Joanne Embree of the pediatric society in Winnipeg said in children over two, ear infections clear up on their own in about 90 per cent of cases.

In deciding whether to prescribe antibiotics, doctors will consult with parents.

"For some children, a discussion will take place with the parents about whether or not a deferral of antibiotics would be appropriate," said Embree.