Routine antibiotic treatment for ear infections called dangerous

Routine antibiotic treatment for ear infections called dangerous

In recent years, the medical profession has come under increased fire for its dangerous practice of treating children's ear infections -- acute otitis media -- with antibiotics. Many M.D.s continue to ignore the evidence and warnings, however, and the growing problem spurred the publication of yet another study on the topic.

In an article focusing on the over medication of ear infections, Larry Culpepper, M.D., of the Boston University School of Medicine and Jack Froom, M.D., of the State University of New York at Stony Brook, reviewed a series of studies -- including seven randomized, placebo-controlled trials -- conducted over the past 30 years.

They concluded: "Given the lack of evidence for benefit and the potential for adverse effects, including altering normal respiratory flora and developing resistant organisms, routine treatment using ten days of antimicrobials for all cases of acute otitis media is not warranted."

Otitis media is inflammation of the middle ear, the cavity between the eardrum and the inner ear. It occurs when an upper respiratory tract infection extends up the passage that connects the back of the nose to the middle ear. Symptoms include severe earache, a feeling of fullness in the ear, decreased hearing, fever and ringing or buzzing in the ear.

In 1980, physicians wrote 12 million prescriptions for antibiotic drugs to treat ear infections. By 1992, that number had nearly doubled to 23.6 million prescriptions.

Drs. Culpepper and Froom noted that as use of antimicrobials increases, bacteria become more resistant: "Antimicrobial use for otitis media alters normal upper respiratory tract flora and leads to the emergence of resistant organisms both in treated children and in the community. The three most common bacterial causes of otitis media...increasingly are becoming resistant."

They went on to write: "Following treatment of otitis media, pneumococci with multi-drug resistance have developed and spread in day care centers and to surrounding communities....Deaths from meningitis resulting from resistant organisms have occurred in patients previously treated for uncomplicated otitis media."

SOURCE: "Questions raised about routine antibiotic treatment for acute childhood ear infections," Journal of the American Medical Association, November 26, 1997.

The Chiropractic Journal.

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