What You Need to Know About Ear Infections

Moms and Dads, this ones for you.  Ear infections are the number one reason for antibiotic prescription in infants and young children, so what do you need to be aware of?  First, the average child under 2 years of age will have 2 ear infections per year.  Risk factors that increase the likelihood of ear infection include: daycare attendance, exposure to cigarette smoke, pacifier use beyond 10 months, and formula feeding.

Since it is likely that you and your child will experience this at some point, here is the best current information to keep in mind:

• Most cases are viral, so antibiotics will be of no help.  Medical offices do not culture the ear fluid to determine if it is viral or bacterial.
• A British Medical Journal study found that 17 children must be treated with antibiotics to prevent just one child from experiencing some pain.
  –Del Mar C.  Are antibiotics indicated as initial treatment for children with acute otitis media?  British Medical Journal 1997; 314(7093): 1526-1529. 

• Use of antibiotics leads to recurrence of ear infections.  A recent study found that ear infections recurred in 63% of children treated with antibiotics compared to 43% of children who got a placebo.
  –Bezakova, N et al.  Recurrence up to 3.5 years after antibiotic treatment of acute otitis media in very young Dutch children: survey of trial participants.  BMJ 2009; 339:b2525.
• Overuse of antibiotics leads to antibiotic resistant bacteria.
• Antibiotics can cause Adverse Drug Events (harmful side effects).  When data was examined from children seeking medical care for an adverse drug event during an 11 year peroid in the U.S. (1995-2005), 585,922 cases were found.  Children 0-4 made up 43% of all visits, and the most implicated drug was antibiotics.
  -Bourgeois FT, et al.  Pediatric Adverse Drug Events in the Outpatient Setting: An 11 Year National Analysis. Pediatrics 2009;124;e744-e750.
• Use of antibiotics may involve serious long term side effects.  It was found that children were 4x more likely to develop asthma if antibiotics were used during the first year.
  -Wickens K, et al.  Antibiotic use in early childhood and the development of
  asthma.  Clinical and Experimental Allergy 1999; 29(6): 766-771.

What about tubes?

• There are potential complications, such as injury to the ear canal, it may lead to hearing loss, the child may have persistent ear drainage, and tubes may lead to cholesteatoma.
• Proven ineffective in children under the age of 3 years.
  -Paradise JL, Feldman HM, et al.  Effect of early or delayed insertion of tympanostomy tubes for peristent otitis media on developmental outcomes at age of three years.  New England Journal of Medicine 2001; 344(16): 1179-1187.

The American Academy of Pediatrics now recommends “wait and see” approach for the first 48-72 hours.

Have you tried chiropractic?

• Current research in pediatric chiropractic is showing compelling outcomes for ear infections, colic, and asthma.  Studies also show promising results for nursing dysfunction, constipation, and neurological disorders (autism, ADD/ADHD).
  -Rosner, A. Infant and child chiropractic care: an assessment of the research.  Foundation for Chiropractic Education and Research. Norwalk, IA 2003.
• In a randomized controlled trial of 57 children with recurrent ear infections, those receiving spinal adjustments had fewer episodes of ear infection and fewer surgical procedures when compared to those receiving routine medical pediatric care.  93% of the children showed improvement, 43% were better within 1-2 treatments.
  -Millis MV, Henley CE, et al.  The use of osteopathic manipulative therapy as adjuvant therapy in children with recurrent otitis media.  Arch Ped Adolesc Med 2003;157(9): 861-66.
  -Journal of Manipulative and Physiological Therapeutics 1996;19(3):169-177.

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