Acute otitis media (AOM), or middle ear infections, are second only to the common cold and the most common infection for which antibacterial agents are prescribed for children in the US. The American Academy of Pediatrics (AAP) recommends a 2-3 day watchful waiting period which leaves the child in pain, can lead to tympanic membrane rupture and is disliked by both parents and physicians.
A 5-7 day systemic antibiotic regimen is administered immediately for children under two, or after the watchful waiting period, if the infection does not self-resolve for children two and older. However, the AAP and American Academy of Family Physicians have reported that, due to advancing drug resistance, the difference in symptomatic relief and pain duration with systemic antibiotics versus watchful waiting is not significantly different statistically.
Systemic Antibiotics - Drug resistance, declining efficacy and side effects.
Antibiotics have been the frontline defense in the treatment of bacterial infections for 65 years. However, global misuse of antibiotics have contributed to the proliferation of drug resistance and declining efficacy. Short term side effects include nausea, vomiting and diarrhea.
Recent studies indicate that repeated use can result in a permanent shift in the child's beneficial microbiome profile that has been implicated in autoimmune disorders such as asthma and allergies, and digestive disorders such as irritable bowel disease and obesity.
