Watchful Waiting May Reduce Unnecessary Antibiotics for Ear Infections in Children: Study
A multicenter study published in Journal of the Pediatric Infectious Diseases Society examined children aged 6 months to 17 years with acute otitis media (AOM) to evaluate the impact of implementing “watchful waiting” strategies on antibiotic use. Researchers found that broader adoption of watchful waiting could significantly reduce unnecessary antibiotic prescriptions, promoting safer and more judicious use of these medications in pediatric populations.
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.
Reference:
Smith, J., Lee, K., Patel, R., & Hernandez, M. (2025). Watchful waiting to reduce unnecessary antibiotics in children with acute otitis media: A multicenter US study. Journal of the Pediatric Infectious Diseases Society. https://doi.org/10.1093/jpids/piaf104
