Pediatric Emergency Medicine Specialist Questions Pediatrician

Antibiotic for my son?

My son has been vomiting and complaining about his ear. I rang his doctor and he prescribed amoxicillin over the phone. After 4 doses of 5mls, he has very watery diarrhea. I rang an out-of-hours doctor about this. They told me to keep taking the antibiotic and that the vomiting and diarrhea may be due to a stomach bug, not an ear infection. They did not examine my child either. I feel he was misdiagnosed. Is it ok to stop the antibiotic as I feel it is causing more harm than good? Also, by stopping it does it increase antibiotic resistance even if wrongly prescribed?

Male | 3 years old

5 Answers

It is more likely that the amoxicillin caused the diarrhea
Most ear infections are viral and do not require an antibiotic it’s true that doctors tend to overprescribe antibiotic thus increasing antibiotic reisistance
It sounds like he had an ear infection from history. Amoxicillin does sometimes lead to diarrhea. A lesser dose of amoxicillin or a different, milder antibiotic could be prescribed or it could be viral.
I would stop the antibiotic. The diarrhea it is likely from the antibiotic. In any case, if he is having diarrhea the antibiotic is just washing through his GI tract and not getting absorbed. It does not put him at any higher risk of a resistant organism to stop the amoxicillin at this point.
You are astute! There’s no way for me to know what the best course of action would be. I would need to know the physical findings of your son’s ears to get started. In a perfect world, a competent physician and then have that person make the judgment call.
Thank you!
Your situation points out the limitations of "telehealth." An ear infection can be suspected based on symptoms, but only diagnosed reliably by physical exam. The majority of ear infections will resolve spontaneously without treatment. This factor underlies the principle of "watchful waiting" that can be employed in many situations. In your particular example, a known side effect of antibiotics - diarrhea - is likely worse than the symptoms that were related to the ear infection. I would recommend stopping the antibiotic. I wouldn't worry about antibiotic resistance with your son. That is a "macro" issue for the most part. If your son is still exhibiting signs concerning for an ear infection, he should be examined.
Good luck.