Antibiotics and Ear Infections

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Prescribing antibiotics for children with ear infections is not much better than no antibiotics at all, says a new study published in The Journal of the American Medical Association, and runs the risk of unwanted reactions and side effects.

For every 100 children with ear infections, the study says, 80 of them would get better in three days without antibiotics. And if all 100 children received antibiotics, only 12 more would improve, but as many as 10 would get a rash and 10 more would develop diarrhea.

Infections of the middle ear in children, technically called acute otitis media (AOM), is the most common condition – as many as 20 million doctor visits annually – for which antibiotics are prescribed for children in the U.S.

Researchers from Mattel Children’s Hospital at UCLA and the RAND Corporation pooled the results of 135 scientifically rigorous clinical trials related to childhood ear infections to contribute to new guidelines to be issued by the American Academy of Pediatrics. The study found a wide variation in diagnostic and treatment approaches across the country, reinforcing the need for new standards and best practices.

Both the pediatricians and the American Academy of Family Physicians have advised for several years that a short wait-and-see period is a valid approach for treating ear infections in otherwise healthy children between the ages of 2 and 12. Parents should watch for symptoms of worsening, such as fever and ear pain. Baby aspirin to treat pain and fever is often all that is required.

Because of stories of ear infections leading to perforated eardrums or mastoiditis (infection of the bone behind the ear), or just wanting to get their child back into daycare or school, too many parents demand antibiotics; doctors, unfortunately, are too often willing to oblige.

Even though many people today are becoming aware of the dangers of overprescribing or misusing antibiotics, more effort should be made to educate all parents. The prescribing physician, with the parent and child right there in the examination room, has the best opportunity to do so.

Parents also need to learn that, if they are going to use antibiotics, stopping them before the full course is done, regardless of side effects such as rash or diarrhea, can lengthen the time and seriousness of infection and lead to the formation of dangerous antibiotic-resistant bacteria. Instead of stopping, parents should immediately call the doctor to see about alternative medication.

A safe and effective alternative to antibiotics for ear infections is a Chiropractic adjustment to correct cervical and spinal misalignments related to the ear. Chiropractic care during the wait-and-see period can help speed the natural healing process, while avoiding unwanted drug side effects.

SOURCE: Journal of the American Medical Association, Nov. 17, 2010

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