What is acute otitis media?

A diagnosis of acute otitis media requires:

• Recent, usually abrupt, onset of illness.
• The presence of middle ear fluid, or effusion.
• Signs or symptoms of middle ear inflammation.

Over 5 million cases of earaches in children occur annually in US children, resulting in more than 10 million annual antibiotic prescriptions and about 30 million annual visits to doctor’s offices. Fifty percent of antibiotics for preschoolers in the US are prescribed for ear infections. Using an observation option could reduce antibiotic prescriptions annually by up to 3 million and would significantly reduce the prevalence of resistant bacteria.

What are the harmful effects of antibiotics?

Each course of antibiotic given to a child can make future infections more difficult to treat. The result is an increase in the use of a larger range of – and generally more expensive – antibiotics. In addition, the benefit of antibiotics for AOM is small on average, and must be balanced against potential harm of therapy. About 15 percent of children who take antibiotics suffer from diarrhea or vomiting and up to 5 percent have allergic reactions, which can be serious or life threatening. The average preschooler carries around 1 to 2 pounds of bacteria – about 5 percent of his or her body weight. These bacteria have 3.5 billion years of experience in resisting and surviving environmental challenges. Resistant bacteria in a child can be passed to siblings, other family members, neighbors, and peers in group-care or school settings.

When should antibiotics be prescribed?

• For children age 6 months and younger – for certain or suspected AOM.
• Children age 6 months to 2 years – for certain AOM or suspected AOM with severe symptoms; observation is an option for suspected or uncertain AOM if non-severe.
• Children age 2 to 12 years – antibiotic treatment for certain AOM with severe symptoms; observation is an option for suspected or non-severe AOM.

The guideline provides an option to observe select children and only start antibiotic treatment if symptoms have not improved in 48-72 hours. Approximately 80 percent of children with AOM get better without antibiotics. And children whose ear infections are not treated immediately with antibiotics are not likely to develop a serious illness.

 

The mainstay of pain management for AOM is medications such as acetominophen and ibuprofen, not antibiotics. Most children with AOM have significant ear pain, which may manifest in young children as ear rubbing, sleep disruption, or temper tantrums. Analgesics are most important in the first 24 hours after diagnosis, especially before the child’s bedtime...Antibiotics do not relieve pain in the first 24 hours, and have only a small effect after that.

 

Published trials of observation, placebo, or non-antibiotic AOM therapy have shown no increased rate of complications, provided that children are followed carefully and receive antibiotics if symptoms persist or worsen.

The potential of antibacterial therapy at the initial visit to shorten symptoms by 1 day in 5% to 14% of children can be compared with the avoidance of common antibacterial side effects in 5% to 10% of children, infrequent serious side effects, and the adverse effects of antibacterial resistance.

 

Parents are often shocked when I explain to them that their child des not have an ear "infection" needing antibiotics but rather has ear "inflammation" that can be handled without drugs. They are even more shocked when after 1 or 2 visits their child no longer has an earache and is perfectly and well and healthy.

     If you've been giving your child antibiotics for repeated ear aches realize that you must break the cycle and do what millions of other Americans have already discovered, Chiropractic care and natural healing methods work.

      Parents not only enjoy the peace and quiet of a good nights sleep when their child's ear pain is gone, but also feel empowered because we teach them how to care for their kids to minimize the expense of doctor visits and prescriptions.

Are Antibiotics Over Prescribed in Children?

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