Academy's earache Rx: watchful waiting
(excerpt from the New York Times )
ATLANTA- Doctors are being advised to withhold antibiotics for two to three days for many children with earaches in an effort to curb the growing problem of antibiotics resistance.
The "watchful waiting" campaign will be rolled out nationwide by the American Academy of Pediatrics this fall. It began in New York in October. ( 2003 )
About 10 Million prescriptions for antibiotics are written every year for kids with ear infections, accounting for nearly half of all antibiotic use among preschoolers.
But 81 percent of the ear problems go away without medication.
Commentary:
Clearly, the rationale for the use of antibiotics for ear infections is questionable when 81% of ear problems resolve without any medication.
One would assume that the American Academy of Pediatrics has authority on setting standards for the treatment of ear infections. While they have clearly recommended withholding antibiotics for several days, this recommendation has not been implemented by most physicians.
Ear infections in children are due to the inadequate drainage of the eustachian tube, the tube that connects the ear to the back of the throat. In children, this tube is more horizontal (while the child is standing) than it is in adults. Since the fluid drains by gravity, it is naturally going to drain more slowly in children because the eustachian tube is not yet at the steep angle it reaches in adulthood. In addition, this tube gets inflamed when there are allergies of any kind. Inflammation of the tube narrows the interior and may close off the tube completely. As a result, fluid backs up into the ear and this warm, moist environment is perfect for bacteria to multiply. Voila- an ear infection.
Prevention of the infection is the primary goal and the most effective way of approaching ear infections. An easy and inexpensive way of preventing future infections is by removing food sensitivities and allergies.
If treatment is indicated, herbs, hydrotherapy or homeopathy can bolster the immune system and speed healing of the infection. While ear drops are sometimes prescribed, it is important not to use any drops or liquids directly in the ear unless you have seen that the eardrum is intact.
NOTE: Any swelling and/or redness in the area behind the ear does need immediate medical attention as it may indicate a serious infection.