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Not Enough Antibiotics

child with not enough antibiotics

My daughter had a rough couple weeks that started as a little cold, turned into bad congestion and just as she was getting better, she got her first ear infection.  The doctor had said to give her antibiotics for 10 days, and we only had enough for 9 days.  I called the pharmacy but they said I must have given the wrong dose.  While that is possible, there should have been enough for 3 more doses than there was, and that seems like a lot of difference.  (And I was very careful to dose it correctly).  She feels great but I know it's important to finish antibiotics all the way through. Is there anything else I should have done?

I’m sorry to hear your daughter has been sick. As long as her symptoms have resolved, nine days of antibiotics should be adequate to treat her ear infection.

In the United States, ear infections are traditionally treated with 10 days of antibiotics. Unfortunately, there is very little medical evidence to support this length of treatment. I am told that doctors on other countries often treat with seven or even five day courses of antibiotics. I also agree with you that it is important to take the prescribed course as partially treated infections lead to the creation of antibiotic-resistant bacteria.

In practice, pediatricians are frequently faced with partially treated infections. Antibiotic courses are cut short when children develop side effects, in the event of an allergic reaction or when medication gets accidentally spilled. I consider an ear infection treated if a child has taken at least 7 full days and no longer has any ear infection symptoms.

You might look at your daughters antibiotic bottle and double check the pharmacy. It should have a total volume often stated like “75 ml when reconstituted”. Liquid antibiotics are shipped and stored in pharmacies as powder. The pharmacist only mixes it with water (reconstitutes) when a patient presents a prescription. This total reconstituted volume should be greater than the sum of all her doses.

In pediatrics, there should always be a little extra as there are always losses on the outside of the syringe or bottom of the bottle. Recently, we are finding an increasing number of pharmacies are short changing our patients. I believe, they are giving minimal amounts of medications in an effort to save money. If this continue to happen, consider using a different pharmacy.



Written April 2014 by
Gregory Gordon MD, Orlando Pediatrician






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