FOR EAR INFECTION, ONE SHOT MAY BE AS EFFECTIVE AS 20 PILLS.

Byline: Denise Mann Medical Tribune News Service

For children with a common ear infection, one shot may be as effective as taking antibiotics for 10 days, a new study suggests.

In the study of 484 children with a middle-ear infection, just over 79 percent of children who received an injection of the antibiotic ceftriaxone in their upper thigh were free of all signs of infection after one month, compared with 80 percent of children who took two oral antibiotics twice a day for 10 days the standard type of treatment for the condition, known as acute otitis media.

Diarrhea, however, was 2.5 times as common in the children who received the shot, Boston researchers reported in the January issue of the journal Pediatrics.

``While we are not recommending (a shot) for all children with otitis media, its advantages are that parents can feel 100 percent confident that their child has received all of the antibiotics needed to treat the infection,'' said lead study author Dr. Elizabeth D. Barnett, an assistant professor of pediatrics at the Boston University School of Medicine.If a child feels better after one to three days of the 10-day antibiotic cycle, he or she may not finish the medication and may have a relapse as a result, Barnett said.

In the study, children who received the shot did not develop new ear infections any sooner than children who took oral trimethoprim and sulfamethoxazole each day for 10 days.But at least one pediatrician isn't ready to endorse a one-shot treatment.

``I have some big concerns over the wholesale adoption of this kind of practice,'' said Dr. Scott Schoem, a pediatric ear, nose and throat specialist at Children's National Medical Center.

When antibiotics are given in large single doses, children may build resistance to them, rendering them ineffectual, he said.

``In very selected cases, the shot provides an advantage over standard oral therapy - and only in those cases would I recommend it,'' Schoem said.For example, the shot may be warranted if a doctor is concerned that a child or the parents would not follow through with the 10-day course of the oral therapy or if the child had previously failed to improve after taking the oral regimen, Schoem said.

Aside from regular checkups, otitis media is the most common reason that children visit a pediatrician. Nearly two-thirds of all children will have had one episode by the time they celebrate their first birthday, and half will have had three or more bouts of otitis media by age 3.