The Treatment Guidelines for Kids with Ear Infections Have Changed

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Updated December 04, 2014.

Antibiotics for Ear Infections

When required, these new ear infection treatment guidelines also offer specific recommendations about which antibiotics should be used. In most cases, the AAP recommends that children be treated with amoxicillin, using a high or double the typical dose of 80 or 90 mg/kg/day. If the amoxicillin doesn't work after 48 to 72 hours or if the child has a fever at or above 102.2 degrees Fahrenheit, then high dose Augmentin or Augmentin ES should be used instead.

After that, or as an alternative if the child is also vomiting, one or three days of intraveneous or intramuscular ceftriaxone (Rocephin) can be used.
Other antibiotics specifically mentioned in the guidelines as alternatives for children with penicillin allergies include cefdinir (Omnicef), cepodoxime (Vantin), and cefuroxime (Ceftin). If the allergy to penicillin included hives or anaphlaxis, then they should be given azithromycin (Zithromax), clarithromycin (Biaxin), or clindamycin.

When prescribed, the guidelines also state that children under age six, and those with severe symptoms, should continue to be prescribed a full ten day course, while older kids may do just as well with just five or seven days of antibiotics.

Conclusions

The AAP guidelines also recommend trying to reduce risk factors by promoting breastfeeding for at least six months, avoiding exposure to passive smoke, not using a pacifier after six months, and not letting your baby have a bottle while lying down.
Will the guidelines make a big difference?

Probably not. There are already specific guidelines about treating kids with sinusitis that aren't always followed and antibiotics continue to be overused to treat colds and sore throats.

The guidelines do offer parents and Pediatricians some 'ammunition' when they want to decrease the use of antibiotics in their children.

Many children are going to meet the criteria of 'severe symptoms' though and will need antibiotics. After all, it is usually the severe ear pain that beings your older child to the doctor, right? And how often has your child had an ear infection and a fever below 102.2?

Still, if your child has an ear infection and you don't think that he needs antibiotics, be sure to ask your Pediatrician if they are necessary or if your child can simply be observed instead.
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