JENNY YOU: Why do children seem to get ear infections so frequently?
DR. ARNOLD: 3 out of 4 children will have at least one ear infection by their third birthday. Ear infections occur in what we call the middle ear. The Eustachian tubes connect the middle ear to the upper part of the throat and help drain fluid from the ear. In children, the Eustachian tubes are smaller and more horizontal so it may make it more difficult for fluid to drain out of the ears. Also, any swelling or blockage with mucus can make it more difficult for the fluid to drain and may raise the risk for infections.
JENNY YOU: What is the difference between the previous guidelines and the new guidelines?
DR. ARNOLD: The criteria they are recommending are more stringent for diagnosing acute otitis media, or ear infections. They refined the criteria to be a little more strict and precise. Sometimes diagnosing ear infections and deciding which ones to treat with antibiotics isn't always straightforward.
JENNY YOU: So they are recommending less antibiotic use?
DR. ARNOLD: They are trying to better ensure that only children who truly need antibiotics receive them. Antibiotic overuse is leading to problems with resistance to drugs and also anytime a provider gives an antibiotic, there's always potential for a medication reaction to the drug.
JENNY YOU: What are they recommending instead?
DR. ARNOLD: Depending on what the health care provider thinks is the most likely diagnosis, based on history and the exam, he or she may prescribe antibiotics right away or may recommend close follow-up to see if the child can improve without them. The article also talked about controlling a child's pain from ear infections.
JENNY YOU: Did the article give any recommendations for kids who get repeated ear infections?
DR. ARNOLD: The study recommended against long-term prophylactic antibiotic use to prevent recurrent ear infections. It also acknowledged that the use of tympanostomy tubes is controversial but could be considered for kids who have recurrent ear infections, 3 episodes in 6 months or 4 episodes in 1 year with 1 episode in the preceding 6 months.
JENNY YOU: Any tips for parents to help reduce ear infections in their kids?
DR. ARNOLD: The article references studies that have shown that breastfeeding for at least 4 to 6 months reduces ear infections. The authors also recommend eliminating exposure to second-hand tobacco smoke, as a way to hopefully reduce the risk of ear infections in infants. Finally, they recommend staying up to date on influenza and pneumococcal vaccinations.