In 2013 the American Academy of Pediatrics began encouraging doctors to treat certain ear infections with what they called “watchful waiting,” an attempt to combat the skyrocketing incidence of antibacterial resistance that was due in part to the overuse of antibiotics.
For me, that meant when exhausted parents showed up in my ER halfway through a sleepless night with a child cradling a painful ear, I could explain to them that in 95 percent of cases the infection is viral and therefore not helped by antibiotics. We could talk about ways to make the symptoms better, how the infection would likely resolve itself in a matter of days. I could point out that starting antibiotics to treat a viral infection could, in fact, cause diarrhea, allergic reactions, and most importantly, antibacterial resistance that could reemerge as a severe and even life-threatening infection in their child in later years.
I could then give the parents a prescription for antibiotics and tell them that if the fever and pain weren’t gone in 48 hours—the point at which most viral infections would have resolved—they could fill the prescription and start the medication.
I have spent hours on these conversations: urging parents to be patient, reinforcing that antibiotic resistance is a real and dangerous side effect, and trying to convince them that waiting is in the best interest not only of their child but of their entire community. The drug-resistant bacteria that develop from unnecessary or inappropriately administered courses of antibiotics are a real risk to children and everyone children “share their cooties with.” I hand over my prescription, ask them again not to fill it for two days, and then call them back ...1
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