- The Washington Times - Sunday, December 10, 2006

PITTSBURGH (AP) — That familiar tug on his ear or restless night’s sleep is usually the sign that little Baedden Pollett has another ear infection. The 2-year-old has had more of them than his parents can count.

Sometimes, his doctor prescribes antibiotics. But in many cases, his parents have waited it out, using Tylenol, warm baths and some extra tender loving care to ease him through it. And he recovers on his own.

More than ever, many parents and doctors these days are taking a “watchful waiting” approach with children older than 2 who have ear infections, the most common childhood illness. Many are foregoing antibiotics because of worries about drug resistance.

“My experience is that parents are often the driving motive behind not giving antibiotics. Parents are very, very concerned about the use of antibiotics,” said Dr. Richard Rosenfeld, director of pediatric otolaryngology at Long Island College Hospital in Brooklyn.

Three out of four children will suffer from ear infections before the age of 3, according to the National Institute on Deafness and Other Communication Disorders. Ear infections occur when viruses or bacteria get inside the ear, usually the result of a cold or other illness.

Antibiotics only work against bacterial infections, though some of the many bacteria that can cause ear infections have grown resistant to certain antibiotics. Doctors have no way of knowing if a virus or a strain of bacteria is causing each infection.

Many parents recognize their child’s earache symptoms — fussing, crying, loss of sleep and appetite and a tugging at the ear. Ear infections can result in hearing loss, though doctors say that’s usually temporary.

A visit to the doctor is advised if a child is sick for a few days and suddenly develops a fever, along with those other symptoms such as ear-tugging and waking at night.

“Observing is different than not treating,” Dr. Rosenfeld said.

In an October study in the medical journal the Lancet, researchers found that antibiotics for ear infections are beneficial only to children under the age of 2 with both ears infected. Study leader Dr. Maroeska Rovers of the University Medical Center Utrecht in the Netherlands said that researchers found that in most other cases, watchful waiting is OK.

Doctors are the front line in helping educate parents about the best course to take, Dr. Rovers said.

“They should not send the parents away by doing nothing, but they should listen carefully to these parents and prescribe sufficient analgesics to treat the pain and the fever in the first few days,” Dr. Rovers said. Then, parents should be encouraged to come back in two to three days if things have not gotten better, he said.

At Children’s Hospital of Pittsburgh, a team of researchers led by Dr. Alejandro Hoberman will lead a government-funded study of about 300 children to further test the watchful waiting versus antibiotics strategies.

Dr. Hoberman, chief of general academic pediatrics at the Pittsburgh hospital, said evidence shows that most infections clear up on their own.

“The key concern is how much longer will it take, and how much pain [and] crying, sleepless nights the child might have,” Dr. Hoberman said.

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