Many children will suffer from an ear infection at some point during childhood. They are most common in children ages six months to two years. As children grow, their ear structures grow accordingly, so they tend to grow out of having ear infections.

Past research has suggested that not all ear infections need to be treated with antibiotics. The American Academy of Pediatrics suggests that immediate antibiotic treatment is not necessary in children when the pain is not severe and/or when the infection is sustained to one ear only. They recommend the "watchful waiting" method - observing your child over two-three days before giving them antibiotics. This recommendation was based findings from certain clinical trials that suggested little benefit of antimicrobial treatment for these cases. Some doctors and parents were also concerned that over-use of antibiotics could lead to bacteria becoming immune to their effects.

This observational approach is best when the child is older than six months, is without severe symptoms and doesn't have any autoimmune or chronic illnesses. It is up to the parent to recognize signs in their child if symptoms worsen. They also suggest using over-the-counter pain medication such as acetaminophen or ibuprofen as treatment.

Recently however, a new study published in the JAMA Pediatrics Journal this week has found that despite the severity of the illness, children between six months and two years that are diagnosed with an ear infection should be treated with antibiotics immediately.

Their study looked at two groups of children. One group was assigned to receive the antibiotic treatment of amoxicillin-clavulanate potassium, the other was given a placebo. The study measured the failure of treatment and looked at the reduction of symptoms over four-five days and the complete resolution of all symptoms by days 10-12.

They found that among children whose infection was in one ear and/or whose illness was non-severe, those treated with placebo had relatively high rates of treatment failure and those treated with the antibiotic had substantially lower rates. This shows that treating the illness with antibiotics gives greater result of recovery from ear infections.

These findings make a case for a uniform approach to antibiotic treatment in all children younger than two years old who have stringently diagnosed ear infections, irrespective of the severity of the illness. It suggests that the AAP guidelines to only give antibiotics to children who have an infection in both ears and/or severe symptoms should be extended to include children whose disease is only in one ear and who are without severe symptoms.