Doctors Refusing to Prescribe Antibiotics for Ear Infections

The Royal Australian College of General Practitioners (RACGP) has released an announcement, as a part of their Choosing Wisely Australia initiative, against the regular prescription of antibiotics to kids with ear infections.

The announcement urges parents to be more aware of when antibiotics need to be prescribed for routine ear infections, and have an active discussion with their GP about it. For most children with middle ear infections (known as otitis media), antibiotics are not required at all, and may even lead to more side effects.

More than 500,000 Aussie kids get ear infections every year, making them incredibly common. However, as antibiotic resistance increases in our population, antibiotic use should not be a knee-jerk reaction but a decision based on a careful assessment of the patient.

RACGP President Dr Frank R Jones had this to say:

“GPs understand the deep concerns parents feel when their child is unwell or in pain. The best way to manage the pain associated with an ear infection is by giving simple analgesics (like paracetamol), carefully adhering to dosage guidelines according to body weight. Antibiotics will have no effect on easing pain and may in fact have unwarranted side effects like diarrhoea.”

According to the RACGP, antibiotics are rarely the most appropriate treatment for a routine ear infection. The RACGP actually recommends that antibiotics not be regularly used for kids with ear infections between two and 12 years old. In most cases, ear infections clear up in a few days of their own accord.

Of course this isn’t true in all cases, and Dr Jones reminded parents that the family doctor is “the best source of information on treatment” of ear infections and if symptoms last more than a few days, or the infection appears more severe and is accompanied by signs like lethargy, they should be taken to the doctor to be assessed. The same goes for kids under two, or those of Aboriginal or Torres Strait Islander origin.

Choosing Wisely & Resistance

The RACGP’s announcement is a part of a large initiative called Choosing Wisely Australia. Its aim is to start important conversations in Australia about whether our healthcare resources are being used effectively, and stopping unnecessary care. One of the big reasons that GPs are urging parents and other doctors to be cautious about how they prescribe antibiotics in particular is because of something called antibiotic resistance.

Dr Lynn Weekes, the CEO of NPS MedicineWise who are facilitating Choosing Wisely Australia, explains:

“Using antibiotics when you don’t need them can contribute to bacterial resistance, both in the individuals and the community. The more antibiotics we use, the more chances bacteria have to become resistant to them and as a result they will lose their power.”

Australia has one of the highest rates of antibiotic use in the world, with one in five people expecting to be prescribed for a simple cold or flu.

Preventing Ear Infections

So what can parents do to stop their children from suffering from painful ear infections? Well, here are a few suggestions from the RACGP.

• Teach your kids to blow their nose instead of wipe it to get rid of mucus, and dispose off tissues and clothes in a hygienic way.
• Make sure they’re washing their hands frequently with anti-bacterial soaps to ensure they aren’t spreading germs and making others around them sick.
• For young children, maintain breastfeeding if possible to prevent against infection. For bottle-fed children, feeding in an upright position can have a positive effect.
• Take care to avoid exposure to cigarette smoke for kids. Passive smoking is a risk factor in developing ear infections.

How do you deal with ear infections?