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New Guidelines for Ear Infections in Children
Doctors' group to recommend not using antibiotics.
By Colette Bouchez
HealthScoutNews Reporter
SATURDAY, Feb. 15 (HealthScoutNews) -- Your 2-year-old wakes up in
the
middle of the night, crying and pulling on her ear. By morning, that
ear is
red and swollen and she's running a fever, too.
If you're like most parents, you bundle up your child and head
straight to
the pediatrician. Once there, you're probably not surprised to
receive a
diagnosis of acute otitis media -- or ear infection -- and a
prescription
for antibiotics, the most common treatment in use today.
However, that scenario may soon change.
A new set of guidelines on otitis media being drafted by a joint
sub-committee of the American Academy of Pediatrics and the American
Academy
of Family Physicians promises to revolutionize the way ear
infections are
treated in children nationwide.
"Essentially the new guidelines will suggest what has already been
stated by
the Agency for Healthcare Research and Quality report and other
literature -- namely, that most children over 2 years of age do get
better
without antibiotics," says Dr. Allan S. Lieberthal.
A pediatrician with the Kaiser Permanente Health System, Lieberthal
is
co-chairman of the joint subcommittee on otitis media.
Experts say younger children are more prone to ear infections, simply
because of their still-immature physiology. Three out of four
children
experience otitis media by the time they're 3 years old, and ear
infections
are the most common illnesses in babies and young children,
according to the
National Institutes of Health.
"The tubes inside a child's ears are tiny, plus they lie in a
horizontal
position, which means they don't drain properly," explains Dr. Joseph
Bernstein, director of pediatric otolaryngology at New York
University
Medical Center.
As time goes by, however, the tubes grow larger and assume a more
vertical
position, so that "by the time a child is 6 or 7 years old, ear
infections
are far less common," Bernstein says.
It's during the early years that infections frequently occur, and
that has
traditionally concerned both doctors and parents. One reason for the
worry,
experts say, was the commonly held fear that, unless treated with
powerful
antibiotics, these infections could result in severe and sometimes
permanent
damage to the ears.
However, while children under the age of 2 may still need
medications to
avoid complications, for the most part, "parents and physicians do
not have
to be as afraid of otitis media as we once were," Lieberthal says.
Studies now show that, generally, an ear infection rarely causes
serious
damage. If the infection doesn't get better on its own in the first
couple
of days, there's still plenty of time to treat with antibiotics --
without
causing harm to the child.
"Certain children may require more aggressive care, but the doctor
should be
the one to make the determination as to what child needs antibiotics
immediately and which one can safely wait it out to see if the
infection
goes away on its own because, in many instances, that is likely to
be the
case," Lieberthal says.
The sub-committee's report, expected to be released this spring, will
reportedly follow treatment precedents already established in most
European
countries, where numerous large-scale studies have found antibiotics
are
often not necessary to clear an ear infection.
One reason for the interest in finding a new treatment regimen is
due to the
growing problem of antibiotic resistance. When antibiotics are
prescribed
too often, bacteria virtually reinvent themselves, becoming stronger
and
more resistant to treatment.
"With judicious use of antibiotics -- only using them when needed
and using
the appropriate antibiotic -- we hope to decrease the development of
resistance. And [this was] most definitely the stimulus for this
committee,"
Lieberthal says.
While only a doctor is qualified to decide if and when a child needs
antibiotics, Bernstein says getting a correct diagnosis is also key.
"There are lots of other problems masquerading as ear infections,
including
allergies, or upper respiratory viral infections," says
Bernstein. "But
neither are true ear infections. They don't need, and won't respond
to,
antibiotics."
Bernstein also cautions parents to recognize that up to 50 percent of
children will still have fluid in their ears four weeks after an ear
infection has cleared. For 10 percent of children, fluid can remain
for
three months.
"But fluid alone, with no other symptoms, is not a sign of a
recurring ear
infection and does not require treatment," he says.
Symptoms of a true ear infection include pain, redness, swelling and
fluid
in the ear, along with fever and, sometimes, a temporary hearing
problem,
Bernstein says.
--
G. Paolo Vanoli (I2VGP) Consulente in Scienza della Nutrizione e Medicine
Biologico Naturali - 
www.medicinaqualita.it
 / Cure naturali /Protocollo
della salute
"......Per una tecnologia di successo, la realtà deve avere precedenza sulle
pubbliche relazioni, dato che la natura non può essere ingannata ...." (By
Feynman)

 middle of the night, crying and pulling on her ear. 
 [CUTTONE]
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