Are Antibiotics Always the Best Path to Treat Sinus and Ear Infections?

May 18th, 2017

antiIf you have a painful sinus problem or ear infection, you just want relief … and swallowing antibiotics can seem like the easiest path to recovery. About 90% of adults in the U.S. end up getting an antibiotic for acute sinusitis from their general practice doctor. Ear infections tell the same story; millions of parents take their children to the pediatrician for ear infections, and most of them end up going home with antibiotics.

But antibiotics may not always be the best remedy, according to recent research. Many medical groups are now recommending that doctors prescribe antibiotics with more caution. Research has shown that 60% to 70% of people with sinus infections recover without antibiotics. About 70% of children get better from ear infections on their own within two or three days, and about 80% are better within a week to 10 days.

There are some real downsides to using antibiotics when they’re not necessary — they can cause upset stomachs, allergic reactions and other problems. And they can contribute to the development of superbugs — infections that are getting harder and harder to cure.

It is difficult for doctors to know what is causing an infection just by observation. Sinus and ear infections can be caused by bacterial infection (for which antibiotics generally work)… but they can also be caused by viruses, drainage problems, and other conditions for which antibiotics definitely offer no help. Antibiotics may be more appropriate to give to certain patients who are less able to fight off infection, such as those with diabetes, or serious heart or lung disease. And antibiotics should be considered in patients with severe sinusitis symptoms.

And there are some kids who definitely should get antibiotics for ear infections, such as those ages 6 months to 2 years who have infections in both ears or any child who has severe symptoms, such as severe pain for several days and a fever of at least 102.2 degrees. Any child who has a ruptured eardrum should also get antibiotics.

The new guidelines recognize the need for physicians to decide the best way to treat each person. Sometimes a “wait and see” approach will give people flexibility … they get a prescription for antibiotics, but are instructed not to use it until they are more certain that the infection won’t resolve on it’s own. The longer symptoms last, the more likely a sinus problem is to be a bacterial infection, some experts say. The new guidelines also recommend ways parents can protect their kids from ear infections in the first place, such as by breast-feeding and keeping kids away from cigarette smoke.