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Watchful Waiting Instead of Immediate Antibiotics Recommended for Many Children’s Ear Infections

Watchful Waiting Instead of Immediate Antibiotics Recommended for Many Children’s Ear Infections

December 17, 2010

Medical Research, Press Releases

BEER-SHEVA, ISRAEL, December 16, 2010 – As middle ear infections increase during the winter months, researchers from Ben-Gurion University of the Negev (BGU) suggest that in many cases the most appropriate  treatment is “watchful waiting” instead of using antibiotics immediately.

The review, published in the scientific journal Expert Review of Anti-Infective Therapy, does not suggest use of watchful waiting in all cases when the infection, also known as Acute Otitis Media (AOM), is suspected by a pediatrician, but notes that a large majority of cases can be treated this way with no long-term ill effects. Currently, watchful waiting is recommended for children over six months of age with mild to moderate symptoms or an uncertain AOM diagnosis.

The authors indicate that watchful waiting could substantially reduce the use of antibiotics in the treatment of AOM and play a major role in helping fight the development of treatment-resistant bacteria. (See table below for complete list of initial treatment recommendations).

“For years, antibiotic therapy was the norm for any child presenting with AOM symptoms,” said Dr. Eugene Leibovitz, lead author of the review, who is a BGU professor and works in the Pediatric Infectious Diseases unit at Soroka University Medical Center.  “However, we soon learned that there are problems with this strategy.  While the antibiotics were killing off most of the AOM-causing bacteria, the few bacteria that managed to survive have developed resistance to that treatment.” 

The review notes that since the introduction of a polysaccharide conjugate vaccine to prevent infections from seven serotypes of the bacteria named Streptococcus pneumoniae, the number of AOM infections associated with these bacteria has decreased. However, AOM infections from bacteria not covered by the vaccine are on the rise. A new vaccine, one that prevents infections caused by 13 serotypes of S. pneumoniae, was recently introduced in routine use in many countries.

“Appropriate antibiotic treatment and vaccine-resistant bacteria remain a problem in managing children with AOM,” said Leibovitz. “With selective guidelines-recommended use of antibiotic therapies and employing watchful waiting in non-critical cases, hopefully, we can discourage the emergence of other treatment-resistant bacterial strains.”

Initial Treatment Recommendations for Children with Acute Otitis Media

AGE

Certain Diagnosis
Severe Disease

Certain Diagnosis
Mild Disease

Uncertain Diagnosis

Less than 6 Months

Antibiotics

Antibiotics

Antibiotics

6 – 2 years

Antibiotics

Watchful Waiting

Watchful Waiting

Over 2 years

Antibiotics

Watchful Waiting

Watchful Waiting

Leibovitz E, Broides A, Greenberg D, Newman N.
Expert Rev Anti Infect Ther. 2010 Feb;8 (2):151-61.

ABOUT AMERICANS FOR BEN-GURION UNIVERSITY

By supporting a world-class academic institution that not only nurtures the Negev, but also shares its expertise locally and globally, Americans for Ben-Gurion University engages a community of Americans who are committed to improving the world. David Ben-Gurion envisioned that Israel’s future would be forged in the Negev. The cutting-edge research carried out at Ben-Gurion University drives that vision by sustaining a desert Silicon Valley, with the “Stanford of the Negev” at its center. The Americans for Ben-Gurion University movement supports a 21st century unifying vision for Israel by rallying around BGU’s remarkable work and role as an apolitical beacon of light in the Negev desert.

About Ben-Gurion University of the Negev

Ben-Gurion University of the Negev embraces the endless potential we have as individuals and as a commonality to adapt and to thrive in changing environments. Inspired by our location in the desert, we aim to discover, to create, and to develop solutions to dynamic challenges, to pose questions that have yet to be asked, and to push beyond the boundaries of the commonly accepted and possible.

We are proud to be a central force for inclusion, diversity and innovation in Israel, and we strive to extend the Negev’s potential and our entrepreneurial spirit throughout the world. For example, the multi-disciplinary School for Sustainability and Climate Change at BGU leverages over 50 years of expertise on living and thriving in the desert into scalable solutions for people everywhere.

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20,000 students | 800 senior faculty | 3 campuses | 6 faculties: humanities & social sciences, health sciences, engineering sciences, natural sciences, business & management, and desert research.

 

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