"Two new studies add substantial weight to one side of a longrunning controversy over whether to give antibiotics to young children suffering from ear infections. The wait and see approach has been enshrined in current guidelines httpaappolicy.aappublications.orgcgicontentfullpediatrics from the American Academy of Pediatrics. Its based on a slew of studies over the past couple of decades indicating that most children with ear infections get better without antibiotics. Some researchers also worry that too many prescriptions are fueling resistance to the drugs. But the new studies from the United States http and Finland http come down firmly on the side of early antibiotic therapy for kids under age  or . Both studies which appear today in the New England Journal of Medicine find these kids get over painful ear infections faster and have less severe symptoms if they get prompt treatment with Augmentin http_and_clavulanic_acidarticle.htm an inexpensive antibiotic often used to treat respiratory infections. But theres a big if. Study authors and other experts say doctors should be sure the child really is suffering from an ear infection before writing that prescription. Article continues after this message from our sponsor Much of the confusion experts say has been caused by studies that werent careful enough about the diagnosis.  If many children in prior studies didnt really have ear infections then its not surprising the antibiotics didnt work for them says Dr. Jerome Klein http of Boston University who wrote an editorial http that accompanies the new studies. But heres the rub  diagnosing ear infections in very young children who tend to squirm is not easy. To do a correct diagnosis says Dr. Alejandro Hoberman httpfindadoc.upmc.comPhysicianBioQuery.aspxID of the University of Pittsburgh the doctor needs to be able to see the childs eardrum which may mean cleaning out earwax first. If the eardrum is red and bulging outward thats a strong sign of a middleear infection. The bulge is most likely caused by pus from a bacterial infection that needs antibiotic treatment. It is a two and sometimes a threeperson operation to see the eardrum says Hoberman who led the US study. Dr. David Spiro http of the Oregon Health Sciences University is an advocate of the waitandsee approach to treating ear infections. He coauthored a  study httpjama.amaassn.orgcontent.full that supported it. But Spiro thinks the pendulum will swing the other way  that is toward immediate antibiotic treatment  because of the new studies. So whats a concerned parent to do Hoberman says they can cut through some of the fog by asking doctors if their child has the telltale bulging eardrum sign that indicates a true ear infection. And he notes they shouldnt be afraid to press their pediatrician. How bulging is the eardrum Is it really bulging this time Or does it look like fluid in the ear Its OK to ask the question Hoberman said."