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Ear Infection Rates Are Down, But We Shouldn't Be Celebrating

Photograph by Twenty20

Ear infections in babies are the worst because it’s not like they can tell you their ears hurt. Instead, you have to try and soothe their crying by feeding them, checking for dirty diapers, making sure they're sleeping enough and, when none of that seems to bring them any comfort, you take them to the doctor and find out they have an ear infection. You end up feeling like a jerk for thinking they were just being fussy and maybe not noticing that they were tugging at their ears.

Thankfully, the number of ear infections have significantly dropped thanks to pneumococcal vaccines, according to new research. This is music to our ears because in the U.S., babies get the vaccines at 2, 4 and 6 months—with a booster administered sometime between 12 and 15 months—and it definitely helps keep those ear infections at bay.

However, the vaccine only protects against a single kind of bacteria that causes ear infections. Worse, doctors almost always prescribe amoxicillin for ear infections, but the bacteria that is now causing a larger number of ear infections is resistant to amoxicillin.

Interestingly, researchers found that although the No. 1 cause of ear infections has gone down, the risk factors for ear infections have not changed significantly since the 1980s. Aside from a family history of getting lots of ear infections, the biggest risk factor is day care attendance—which isn't much of a surprise since anyone who takes their kids to day care knows they're basically a germ factory.

Before the introduction of the pneumococcal vaccine in 2000, more than 80 percent of kids had experienced at least one ear infection by the time they were 3 years old. In 2010, an even more effective vaccine known as PVC13 was introduced (basically an upgraded version of the original vaccine). This recent study found that after pneumococcal vaccines were introduced, about 60 percent of kids had experienced at least one ear infection by the same age.

This is great news, but before you think your kids are free and clear from ear infections as long as they get pneumococcal vaccines, there's more you need to know.

Although the drop in ear infections was bigger than expected by researchers, study author Dr. Michael Pichichero, director of the Rochester General Hospital Research Institute in Rochester, New York, said they've found that there's a shift in the kind of bacteria causing infections. "If something is not done, I would expect ear infections to come back in frequency," Pichichero explained. And, to make it tougher, about half the strains of the two kinds of bacteria not covered by the pneumoccocal vaccine are resistant to amoxicillin, the antibiotic routinely prescribed to treat ear infections.

The problem with that is when a child is diagnosed with an ear infection, doctors don't normally test the middle ear fluid to see what type of bacteria is present. Therefore, they can’t know with certainty what's causing the infection and may end up prescribing antibiotics that don't work.

What does this mean for parents? If your child is prescribed antibiotics and you see no improvement within a few days, talk to your pediatrician—it's possible that the infection is resistant to the antibiotic.

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