Antibiotics For Ear Infections Prescribed Less, Antibiotic Overuse Rates Declining

Doctors are prescribing antibiotics for ear infections less, resulting in declining rates of antibiotic overuse, says a new study published in the July 2012 issue of the journal Pediatrics.

For the study “Trends in Antibiotic Use in Massachusetts Children, 2000–2009,” researchers from the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute in Boston, Massachusetts noted that the overall rates of prescribing antibiotics for children decreased throughout the 1990s and early 2000s. One of the main reasons for the decrease was a decrease in prescribing antibiotics for ear infections.

To determine the reason for the decline in antibiotic-prescribing rates, the researchers gathered data on antibiotic dispensings and diagnoses on children between the ages of 3 and 72 months from 2 health insurers in 16 Massachusetts communities between the years of 2000 to 2009.

According to recent research published in the Journal of the American Medical Association, prescribing antibiotics for ear infections is only modestly more effective than no treatment. However, because antibiotics for ear infections cause adverse reactions in 4 to 10 percent of children, researchers have begun recommending that doctors wait to allow the ear infection to resolve without intervention before prescribing antibiotics.

As David M. Spiro, MD, MPH, told WedMD, “In this country, 96% to 98% of physicians treat ear infections immediately with antibiotics, even though most cases will resolve on their own without treatment.”

The overuse of antibiotics for ear infections is a contributing factor to antibiotic overuse. The overuse and misuse of antibiotics results in antibiotic resistant superbugs, which are a growing worldwide public health concern.

In the present study, the researchers discovered that the antibiotic-prescribing rates for children age 3 to 24 months decreased by 24 percent between 2000 and 2009, the rates for 24 to 48 months decreased by 18 percent, and the rates for 48 to 72 months decreased by 20 percent.

For the children age 3 to 48 months, the antibiotic-prescribing rates declined until 2005 before stabilizing. The rates for 48 to 72 months stabilized in 2002.

More significantly, the use of antibiotics for ear infections declined by 14 percent.

However, doctors were not simply prescribing antibiotics for ear infections less. Instead, doctors were diagnosing fewer ear infections in children: The diagnosis rate for ear infections decreased by 9 percent during the time period of the study. The treatment rate for prescribing antibiotics for ear infections remained at 63 percent.

In other words, antibiotics for ear infections were prescribed less because doctors were diagnosing fewer ear infections than previously.

As the researchers conclude, the use of antibiotics should continue to be monitored in an effort to prevent antibiotic-prescribing rates from rising again and ultimately to prevent antibiotic overuse. At least in the Massachusetts communities involved in the study, prescribing antibiotics for ear infections less decreased the overall rates of antibiotic use between 2000 and 2009. However, as the researchers add, the present data may be precise for the communities studied but may not represent trends in other parts of the United States.

Further research needs to be conducted on antibiotic overuse rates in areas outside of Massachusetts.

Does your doctor overprescribe antibiotics for ear infections?