Antibiotic Choices in Acute Ear Infections- Does Convenience Lead to Treatment Failure?
Macrolide antibiotics (such as azithromycin) are popular choices when treating acute ear infections in children due to a short (5 day) course of treatment, once-daily dosing, and low incidence of gastrointestinal side effects. However, macrolide antibiotics, while generally effective against the most common pathogens in acute ear infections in children (streptococcus pneumoniae, haemophilus influenzae, and moraxella catarrhalis), are quickly losing effectiveness as resistant strains of bacteria increase. A 2007 study by the CDC demonstrated a 22.7% rate of macrolide resistance among strep. pneumoniae isolates (the most common cause of ear infections). 2004 recommendations from the American Academy of Pediatrics and the American Academy of Family Physicians advised against the use of macrolides for acute ear infections unless a patient has an immediate-type allergic reaction to penicillin. However, the rate of macrolide prescription continues to dwarf the documented rate of immediate-...