Watchful Waiting May Reduce Unnecessary Antibiotics for Ear Infections in Children: Study

The study included data from health systems across Illinois, Colorado, and Utah, spanning 2018 to 2023. Children with mild-to-moderate AOM symptoms were monitored without immediate antibiotic intervention, while those with severe or high-risk presentations received standard treatment. Outcomes measured included rates of antibiotic prescription, symptom resolution, and subsequent complications. Results demonstrated that delayed prescribing in appropriate cases did not increase adverse events while substantially lowering overall antibiotic use.

Authors emphasized that watchful waiting provides a practical approach to antimicrobial stewardship in pediatric care. Reducing unnecessary antibiotics can help limit resistance, decrease medication-related adverse effects, and foster more individualized patient management. The study supports updating clinical guidelines to incorporate evidence-based criteria for delayed antibiotic therapy, particularly for otherwise healthy children with non-severe AOM. Future research may explore integrating telehealth follow-ups and parent education to further enhance the safety and effectiveness of this strategy.

Keywords: acute otitis media, AOM, watchful waiting, antibiotic stewardship, pediatric infections, Journal of the Pediatric Infectious Diseases Society