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Children with common ear infections should not get antibiotics, watchdog says

Children with common ear infections should not be given antibiotics, a health watchdog has said


New draft guidance from the National Institute for Health and Care Excellence (Nice) says parents should treat the infections with paracetamol or ibuprofen instead.

It comes a few days after the US Centres for Disease Control and Prevention also warned parents that antibiotics are not suitable for many common conditions.

On Facebook, it said: “Antibiotics are not effective against viral infections like the common cold, flu, most sore throats, bronchitis, and many sinus and ear infections.

“Taking antibiotics can also have harmful side effects for you or your child.”

The Nice guidance relates to acute otitis media – an infection that occurs in the middle ear and is common in children and young people.

Evidence from Nice found that about 60% of children will show signs of improvement – such as less pain – within 24 hours, even if they have not taken antibiotics.

Nice said some children may need antibiotics immediately, such as those who are very unwell or have symptoms of a more serious illness.

Children with discharge from the ear caused by a burst ear drum should be offered antibiotics immediately or given a prescription to use if symptoms do not improve, or get worse, within three days.

Professor Gillian Leng, deputy chief executive and director of health and social care at Nice, said: “Once finalised, our advice will support GPs and healthcare professionals to decide whether or not to use antibiotics.

“We are all too well aware of the dangers we are facing with antibiotic resistance, so it is vital these medicines are only used when they are effective.

“The evidence shows antibiotics are not needed by most children and young people with middle ear infections.

“We must make sure the people who need them are given them, but routine prescribing in all cases isn’t appropriate.”

Dr Tessa Lewis, GP and chairwoman of the managing common infections guidance committee, said: “Many toddlers and children with this type of ear infection will get better within a few days by managing their pain with paracetamol or ibuprofen at home.

“It’s important that they receive the right dose of painkiller at the right time.

“If they don’t improve within a few days, the draft guidance advises GPs consider a back-up antibiotic prescription.

“This approach should help reduce the over-use of antibiotics for this common ear infection.”

Figures suggest one in four children will have at least one middle ear infection before they reach 10.

The infections are most common between the ages of six and 15 months.

Earlier this week, the World Health Organisation (WHO) warned that the world is running out of antibiotics.

It said growing bug resistance to the drugs could “seriously jeopardise” progress made in modern medicine.

The WHO described antimicrobial resistance as “a global health emergency”.

Side-effects of antibiotics include vomiting, nausea, diarrhoea and loss of appetite.

Around one in 15 people have an allergic reaction to antibiotics, especially penicillin and cephalosporins, according to the NHS.

Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: “Ear infections can be horrible – and distressing, particularly for children and parents whose children are in pain – but they usually clear up on their own without antibiotics, so we welcome this draft Nice guidance today.

“GPs are making great strides in reducing prescriptions for antibiotics for many conditions, so it’s important that we get the message out to patients that antibiotics are not always the answer to minor, self-limiting conditions such as ear infections, colds and sore throats.”

According to the NHS website, antibiotics should not be routinely used to treat middle ear infections as there is no evidence that they speed up the healing process. It says many cases are caused by viruses, which do not respond to antibiotics.

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