This news story about a study measuring longer versus shorter courses of antibiotics for younger children with ear infections lacks important detail, because it’s mostly just a shortened rehash of the news release.
For one, it doesn’t make it clear that research indicates that antibiotics seem more effective in younger kids versus older kids, and that’s why this study was focusing on this younger age group. Without this detail, it’s likely to leave parents with the wrong impression that treating all ear infections with longer courses of antibiotics is the right thing to do.
The story also didn’t adequately discuss the potential harms in prescribing antibiotics to children who don’t need them, as well as the growing problem of antibiotic resistance.
The more useful way to report on this study is not in isolation, but rather, by taking a step back and answering: How does it fit into the vast body of already published studies of antibiotic treatments of otitis media (ear aches)?
No mention of costs was included in the news story.
The discussion of benefits is misleading. The story tells us that “the risk of treatment failure was 34 percent in the five-day group and 16 percent in the 10-day group,” but what does that mean? “Treatment failure?”
According to the study abstract: “the mean symptom scores at the day-12-to-14 assessment were 1.89 versus 1.20 (P=0.001).”
We are talking about a 14-point pain scale, where 0 is low and 14 is high. So do we know if an average 0.69 difference in pain scales makes any difference? Any report on the alleged “benefits” of the long versus short treatment should discuss this minor difference.
The story mentions there were no differences in the rate of antibiotic resistance, diaper rash or diarrhea. This is just enough information to rate satisfactory–but barely.
But unfortunately we know those markers would likely be higher in a cohort of kids taking antibiotics, versus those taking nothing (placebo). Without a placebo arm in this trial, we have no idea what the rate of adverse effects would have likely been. A stronger story would have pointed this out.
The story provides some important details on the study, but didn’t discuss limitations–this earns it a not satisfactory score.
Ear aches are a real and present concern of parents with young children.
The disclosure form from the New England Journal article tells us that “Drs. Hoberman and Martin report receiving consulting fees from Genocea Biosciences; and Dr. Hoberman, receiving grant support from Ricoh Innovations and holding pending patents related to the development of a reduced clavulanate concentration version of amoxicillin–clavulanate potassium (U.S. patent application serial number, 14/371,731) and the development of a method and apparatus for aiding in the diagnosis of otitis media by classifying tympanic-membrane images (U.S. patent application serial number, 14/418,509). No other potential conflict of interest relevant to this article was reported.”
This potential conflict of interest information was not in the HealthDay story.
This rates not satisfactory by virtue of the fact it didn’t mention the one alternative that the evidence suggests might be best, at least for older kids: Doing nothing except treating the pain.
The story just generally refers to the drugs used as “antibiotics” making it unclear what specific drug was studied. Without that information, availability is impossible to even infer.
This story doesn’t make it clear that researchers are trying to hone in on specifically how best to treat younger kids with ear infections, compared to older kids.
The story is reliant on the news release, but we were pleased that it does disclose this openly. However, all the content seemed to be copied or minimally rewritten from the news release. There is nothing in the story that didn’t also appear in the release, such as an independent perspective.