Ear infections are very common in young children. In fact, by age three, more than two thirds of children will have had at least one episode of acute otitis media (bacterial ear infection), says Dr Bastian Seidel, President of the Royal Australian College of General Practitioners (RACGP).
While the issue is common, treatment isn't always straightforward.
If your child is in pain, painkillers such as paracetamol can help. Local anaesthetic eardrops can also ease your child's discomfort.
But when it comes to antibiotics, things get a little murky.
In most cases, antibiotics aren't needed. One quarter of ear infections are viral, explains Dr Seidel, meaning antibiotics won't help.
When it comes to bacterial infections, most of these resolve spontaneously too (without the need for antibiotics), according to Clinical Practice Guidelines from the Royal Children's Hospital (RCH).
Those guidelines say that antibiotics only provide a "small reduction in pain beyond 24 hours in only about 5 per cent of children treated".
Mind you, Dr Seidel says children with persistent symptoms, those with a poor immune system, and those who have underlying medical problems may benefit from the use of antibiotics.
When antibiotics are needed, your child may use either a five or 10 day course.
Some people may assume it's better to take a shorter course. After all, no one wants to overuse antibiotics or use them longer than needed.
Others might lean towards a longer course. If you're giving your child antibiotics, you want to make sure you've used enough to kill the infection adequately.
This naturally begs the question: Are children with ear infections better off having a five day course of antibiotics, or 10 days?
A new landmark trial published in the New England Journal of Medicine examined this exact question.
The study followed 520 children with acute otitis media who were either given a 10-day course of antibiotics, or a five-day course of antibiotics (with five days of placebo pills).
The results found that the 10-day course of antibiotics was more effective at treating the infection.
There were also no increased risks of adverse events such as diarrhoea or nappy rash.
Dr Alejandro Hoberman, the study's author, said that the results "clearly show" that a five day course of antibiotic offers no benefit in terms of adverse events or antibiotic resistance, and that "the benefits of the 10-day regimen greatly outweigh the risks".
Currently in Australia, the RCH guidelines advise prescribing antibiotics for five days.
Then, if symptoms don't improve within the first 48 hours, a further five days of antibiotics may be prescribed.
This means it's not current practice in Australia to prescribe a 10-day course of antibiotics for ear infections straight from the start.
While Dr Seidel found the results of this study "interesting," he says we shouldn't rush to change our guidelines here, as our current ones are still valid.
If your child develops an ear infection, he says the best thing you can do is see your GP early on to discuss treatment options.
"Your GP will always make a clinical discussion based on best contemporary evidence and your personal needs and circumstances."
Essential Baby