Below is a news release on a clinical practice guideline published jointly by the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). The guidelines are posted on the AAP and AAFP Web sites at http://www.aap.org and http://www.aafp.org/x26481.xml

For Release: March 9, 2004, 4:00 pm (CT)

CHICAGO, Ill and LEAWOOD, Kan - Millions of children every year suffer painful ear infections. And every year, parents look to their child's doctor for help in easing the pain. The American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) have released new guidelines to help physicians and parents decide on the best treatment for acute otitis media (AOM), or middle ear infection.

AOM is the most common bacterial illness in children and the one most commonly treated with antibiotics. Says Allan Lieberthal, M.D., FAAP, co-chair of the guideline panel, "Accurate diagnosis of AOM is the key to this guideline. We need to make sure that the child has AOM before prescribing an antibiotic. If a child is given an antibiotic and doesn't need it, he or she may build up an antibiotic resistance and not respond to them when needed for a more serious infection, such as pneumonia or meningitis." The guidelines stress that about 8 in 10 children with ear infections get better with no antibiotics at all.

According to Ted Ganiats, M.D., a family physician in San Diego, Calif., and co-chair of the guideline panel, the most important step to take in the case of any ear infection is to relieve the child's pain. "We want parents and doctors to first make the child comfortable with pain relievers such as ibuprofen and acetaminophen. Antibiotics do not relieve pain during the first 24 hours and do not reduce fever any quicker or better than pain medicines," he said.

Antibiotics may be the right choice for children up to the age of 2 who have ear infections, not just fluid in their ears. They may also be appropriate if a child is very sick or has a high fever. The guideline provides an option to observe select children and start antibiotic treatment only if symptoms have not improved in 48-72 hours. The guideline also notes that 80 percent of children whose ear infections are not treated immediately with antibiotics get better on their own and have no increased risk of a serious infection.