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Antibiotics speed up recovery from ear infections in young children, studies show

Rating

4 Star

Categories

Antibiotics speed up recovery from ear infections in young children, studies show

Our Review Summary

Of four stories we reviewed on this study (Washington Post blog, NPR, Los Angeles Times as well), two were blog pieces – this one and the Washington Post entry.  This CNN effort was better in most ways than the opinionated blog from the Washington Post. It earned points for sticking to the evidence and providing independent perspectives about the value of antibiotics for treating childhood ear infections. We also applaud the story’s focus on shared decision-making between doctors and parents when managing ear infections. A bit more detail on costs and harms would have added value to this excellent story.

 

Why This Matters

Wanting the best for a child with an ear infection doesn’t necessarily mean opting for the most aggressive treatment. As Dr Richard Rosenfeld  puts it in this story: “Medicine is about gray zones and balancing the risks and benefits. Parents and doctors need to understand what the benefits and what the downside of treatments are.” While the research discussed here confirms that antibiotics are likely to be beneficial for certain children with ear infections, no study can take the place of a careful consideration of individual circumstances. According to Rosenfeld: “It’s an opportunity for a conversation with your pediatrician.”

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

This story did not discuss the costs of antibiotic prescriptions to the individual or costs of policies on our health care system and society. We think it should have.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

Although a bit more detail would have been useful on the findings from both studies, the story does provide an account of the absolute rate of symptom relief after 7 days for antibiotic (80%) and placebo-treated (74%) patients, which is the expectation for this criterion. It also provides valuable expert commentary on how parents can put these benefits into context vs. the risk of harm and the likelihood of spontaneous recovery in children who don’t receive antibiotics.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Although we’re tempted to give this story a pass for providing a detailed list of potential harms and a better explanation of why limiting antibiotic use can be beneficial (it can “increase the chance the future use of antibiotics will be effective”), the expectation here is that the story will provide a quantitative estimate if available. These figures were easily obtainable from the original studies, and should have been provided.

Does the story seem to grasp the quality of the evidence?

Satisfactory

This story takes a much more careful approach to examining the evidence than the competing Washington Post blog. Examples:

  • It correctly observes that the study results actually confirm current treatment guidelines regarding the use of antibiotics in children younger than two who have a well-documented ear infection. These guidelines state that such children should be given antibiotics immediately.
  • Side effects are discussed early and prominently.
  • The story points out that there is evidence to support a watchful waiting approach in children over the age of two, and that antibiotics are not universally recommended for all children with ear infections.
  • The story quotes an expert who points out that the differences favoring treatment were “not huge” in one of the studies. Although we wish there had been some discussion of the findings of the second study, which found larger benefits, this was an important point to make.
  • The story notes that the findings apply only to children who have a confirmed ear infection diagnosis.

Does the story commit disease-mongering?

Satisfactory

No disease-mongering in this story.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The prominence of the independent voices in this story is a real strength of the coverage. It was nice to see lengthy comments from Dr. Richard Rosenfeld, who literally wrote the book (or at least edited it) on evidence-based treatment of ear infections. There’s also input from a doctor who is a stronger proponent of early antibiotic use.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story adequately describes the rationale supporting watchful waiting, which is the primary alternative to antibiotics for an acute ear infection.

Does the story establish the availability of the treatment/test/product/procedure?

Not Applicable

The availability of antibiotics to treat ear infections is not in question.

Does the story establish the true novelty of the approach?

Satisfactory

The story correctly characterized the novelty of the research: it establishes that antibiotics are more effective for infants and toddlers with a conclusive ear infection diagnosis, and supports current U.S. guidelines for providing immediate antibiotics to such children.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story features comments from two independent experts, so we can be sure it’s not based on a news release.

Total Score: 7 of 9 Satisfactory

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