Researchers looking into whether a shorter course of antibiotics would treat young children’s ear infections as well as a longer course found that not only was the shorter treatment less effective but it didn’t reduce antibiotic resistance or side effects.
The study, published in the New England Journal of Medicine, comes as physicians and researchers are looking for ways to curb the unnecessary use of antibiotics, including the possibility of using them for a shorter time against some common infections. The goal is to prevent bacteria from developing resistance to antibiotics. While that strategy didn’t pan out in this particular study, shorter antibiotic courses are still being used and studied in other contexts.
The study included 520 children between 6 and 23 months old who were diagnosed with an acute middle ear infection, a very common childhood illness. Half of the children were randomly assigned to receive 10 days of the antibiotic amoxicillin-clavulanate, while the other half received five days of the drug plus another five days of a placebo. If the children experienced another ear infection during the period they were in the study, they received the same treatment. Parents, researchers and clinicians didn’t know which treatment a child was getting.
The kids were tracked for the severity of their symptoms and had regular office visits to check their health, plus additional visits if they were ill. The researchers also checked to see if their throats had been colonized by bacteria that were resistant to the antibiotic.
The researchers found that initial treatment failed in 34 percent of the children treated with the five days of antibiotics, compared with 16 percent of children who had the longer treatment. Symptoms were also worse in the group that received the shorter treatment regimen. And there was no difference between the groups in the rate of colonization with antibiotic-resistant bacteria.