Otitis media in young children: How much antibiotics is still healthy? – Knowledge

When young children have urinary tract infections, severe skin infections, and middle ear infections, they are often given an antibiotic. Photo: Joanna Zielinska – stock.adobe.c // nt

Taking the medicine can weaken the effect of vaccinations. What does this mean for children’s health?

The main thing is to get better – for many people, not every remedy is correct, but one thing remains: antibiotics. But especially with young children, you have to be careful about the gift. An American study showed that taking antibiotics for young children can reduce the protective effect of vaccinations – for example against hepatitis, mumps or measles. In this overview, we explain why this happens and what to consider in the regulation.

How did the low protection come about?

In the study, 560 children from the age of six months until their second birthday were regularly examined and blood samples taken. If children developed a middle ear infection, blood samples were also analyzed. Of the 560 children examined, 342 received antibiotics during the first 24 months of life – 218 did not receive them. He found that, on average, antibody levels in children treated with antibiotics were lower than in children not treated with antibiotics. The amount of antibodies was often below the set value that would ensure good protection against disease when children were given antibiotics between the ages of nine to twelve months. If the antibiotics were administered multiple times, this had an increasing negative effect on antibody values.

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How does this effect occur?

“Antibiotics, often prescribed in early childhood to treat middle ear infections, attack not only dangerous bacteria in the ear, but also beneficial bacteria in the gut microbiome,” says Cornelia Gocek of Martin Luther University Halle-Wittenberg Health Science Profile Center. “The balance of bacteria with our immune system is disturbed and it is conceivable that vaccinations no longer show their full effect.” However, according to the expert, this is only a theory, because the study did not examine the gut microbiome.

Do children who take antibiotics get measles, mumps, and the like, despite vaccination?

If the minimum level of antibodies to vaccination is not reached, there is a fear that only low protection will be provided, says Claudius Meyer of the Center for Pediatric and Adolescent Medicine at the University Medical Center Mainz. However, the study does not show that the vaccination response was completely absent. Infected children can certainly get a certain degree of protection against measles, mumps, and the like. Especially since antibodies are only part of the immune response to a vaccine.

Should children be vaccinated?

It cannot be said whether children should be vaccinated again on the basis of this study, says pediatrician Meyer. “Follow-up at age three or five may be useful to determine the need for a booster.” In some countries, some of the vaccines under study are boosted during childhood anyway.

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Are children permanently harmed by taking antibiotics?

From birth, the development of the intestinal flora varies greatly from one individual to another – meaning that the effects of antibiotics can also vary greatly, according to Claudius Meyer. Studies conducted in recent years have shown that the development of the intestinal flora in children is not completed until between the ages of three and five. “Recovery is supposed to occur, but it is currently still unclear whether recovery has been completed in each case.” And taking probiotics, which are meant to protect the gut microbiome while taking antibiotics, could reduce the effect observed in the study, his colleague Cornelia Gocek of the University of Halle-Wittenberg, adds.

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What should be considered when giving antibiotics in the future?

Friedrich Reichert, medical director of the Children’s Emergency Room and the Department of Pediatric Infectious Diseases at the Klinikum Stuttgart, emphasized that the number of antibiotics prescribed in the field of pediatric and adolescent medicine has decreased dramatically in recent years. “We now know that middle ear infections rarely need to be treated with antibiotics, that the majority of airway infections in children do not heal faster with antibiotics, and that antibiotic treatment, if started, can be much shorter than previously thought. Study confirms For Richert that faltering prescription habits should be questioned and continually adapted to the current state of knowledge.“It is important when antibiotics are given—if they are necessary—that a targeted antibiotic should be used and the duration of treatment should be as short as possible.” But it should also be clear: “Antibiotics are safe and important medicines that, if used correctly, ease suffering and save countless lives.”

What childhood illnesses are treated with antibiotics?

The main causes of antibiotics in young children are acute urinary tract infections such as pelvic inflammatory disease, severe skin infections, more complex middle ear infections, and, rarely, lower respiratory tract infections such as pneumonia. But it is also known that many of them recover easily without antibiotics, explains Friedrich Reichert of the Stuttgart Clinic.

If there is a very rapid improvement after starting treatment, you can discuss with your doctor whether treatment can also be terminated earlier – the previous creed “you always have to take the package ready, otherwise resistance will develop” has been vividly disproved, explains pediatrician Friedrich Reichert of the Stuttgart Clinic. “The pressure of antimicrobial resistance always arises from giving an antibiotic, never from not giving it.”

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