Drug-Resistant Ear Infection

Most kids get ear infections. The American Academy of Pediatrics (AAP) estimates that 90 percent of children have at least one ear infection before they start school (see Reference 1). If the infection is caused by bacteria, a pediatrician will usually prescribe antibiotics. However, if the infection is viral, antibiotics should not be used. Overuse of antibiotics helps bacteria become resistant, meaning there are fewer effective treatments for ear infections.

Superbug

• Luckily, the frequency of drug-resistant ear infections appears to be relatively rare, according to CanWest News Service (see Reference 2). These infections are caused by a superbug first discovered in 2007, called 19A. It is a superbug because it has adapted and is not affected by any of the 18 drugs that have been approved to treat childhood ear infections.

  There is one antibiotic, levofloxacin, that might treat drug-resistant ear infections, but it has only been approved for adults.

Bacteria Mutate

• Bacteria that cause ear infections constantly evolve. When repeatedly exposed to antibiotics, it becomes easier for bacteria to mutate. The antibiotics lose their ability to harm the new strain of bacteria, making them ineffective. Bacteria mutate faster than researchers can develop new, effective antibiotics.

  The Centers for Disease Control and Prevention (CDC) believes that antibiotic resistance is a critical public health issue (see Reference 3). It affects everyone who develops a bacterial illness that used to respond to antibiotics. Childhood ear infections that formerly cleared up with antibiotics now have fewer treatment options. As a result, the ear infections can be prolonged and might even lead to hearing loss.

Antibiotic Overuse

• Before the routine use of antibiotics began in the 1940s, people sometimes died from bacterial infections. When doctors began prescribing the new drugs, mortality from infections decreased. However, through the years, bacteria have become resistant because of overexposure to antibiotics.

  "Science Daily" notes that experts have encouraged pediatricians to find out whether ear infections are caused by viruses or bacteria before routinely prescribing antibiotics (see Resource 1). Doctors can do this with a simple procedure called tympanocentesis, or an ear tap. However, many doctors do not use this procedure and instead broadly prescribe antibiotics for all ear infections, leading to drug-resistant bacteria.

Treatment Guidelines

• Responding to concerns about drug-resistant ear infections, the AAP developed guidelines for treatment (see Resource 2). Ear infections are one of the most common reasons that children see a doctor and the most likely reason to get antibiotics.

  Among other recommendations, the AAP suggests pain management and allowing a child to fight an ear infection for 48 to 72 before prescribing antibiotics. It also suggests that mild antibiotics such as amoxicillin are appropriate for most children. Each course of antibiotics makes future ear infections more difficult to treat, so it is beneficial to reduce their widespread use.

Non-Antibiotic Treatments

• Many doctors now adopt a wait-and-see attitude to treating ear infections while striving to minimize the child's pain. Over-the-counter pain relievers such as acetaminophen can help with ear discomfort. Hot compresses on the ear help circulation and might speed healing. Herbal remedies such as elderberries and echinacea might inhibit viral growth and strengthen the immune system (see Resource 3).