Doctors Still Give Antibiotics For Ear Infections Despite Guidelines
In Touch Education Services
A study presented at the December 2011 clinical meeting of the American Society of Health-System Pharmacists finds that doctors are still prescribing antibiotics for ear infections despite guidelines to the contrary.
The 2004 guidelines set forth by the American Academy of Pediatrics and the American Academy of Family Physicians on the management of acute otitis media have not appreciably altered doctors' antibiotic prescribing habits.
Margaret L. Hitzeman, who is a PharmD candidate, and Donald G. Klepser, PhD, both from the University of Nebraska in Omaha say that before the guidelines were issued in 2004, 87% of physician visits for acute otitis media resulted in an antibiotic prescription being written.
The percentage dropped to 84% between 2004 and 2006, but fell back to 88% in 2007 and 2008.
"The guidelines recommended a watch-and-wait approach for 72 hours before offering antibiotic treatment, but go ahead and treat for pain with agents such as ibuprofen or acetaminophen. If the patient remains febrile, then begin high-dose amoxicillin," Hitzeman explained.
"Since the guidelines came out, a number of opinion papers have pointed out that physicians are uncomfortable not prescribing antibiotics for acute otitis media, and there is also considerable patient demand," she said.
"It will be interesting to see when the next set of guidelines is published if they stick with the initial watch-and-wait approach [because] physicians don't seem to be willing to follow the recommendation," she added.
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Ear Infections In A Nine-Month-Old Resolve Under Chiropractic Care
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The June 21, 2010 issue of the Journal of Pediatric, Maternal & Family Health -- Chiropractic reports on the case of a nine-month-old boy who experienced resolution of his recurring ear infections (otitis media) in a very short time after beginning chiropractic care.
His mother brought him to the chiropractor complaining that he had recurring ear infections every three weeks and his medical doctor was talking about the possibility of inserting ear tubes in his ears along with the antibiotics and antihistamines he was being given.
He was born via caesarian section and had no other history of head first falls. His mother stated that his ear infections began at four months of age after receiving his vaccinations. The mother took no medications during pregnancy and didn't smoke or drink alcohol. The boy was breastfed for the first three months, formula for the next three months and began solid food at six months. No cow's milk has been given to the child and there were no reported food or juice allergies or intolerances.
His initial chiropractic examination consisted of spinal thermal scans that assess skin temperature differences on either side of the spine. While equal readings are expected, unequal readings indicate areas of spinal involvement. This patient's exam revealed he had spinal subluxations in the cervical, thoracic and sacral areas of the spine as well as slight torticollis of the neck. He was placed on a program of three visits per week with an assessment every visit.
After his first adjustment, he did not sleep well that night and returned the next day for a follow-up visit and another adjustment. Two days later, his mother said he was doing better and had "slept great." He was adjusted again and sent home.
The following week, his mother reported he was not sleeping well and pulling at his right ear. Both ears were examined and were clear of fluid. He was adjusted that day and twice more that same week.
During the third week of care he was again checked and adjusted three times and by the end of the week was doing better and no longer pulling on his ears.
He was re-examined during the fifth week of care. His mother reported that he had not had any ear infections since beginning his care program and that he was taking longer naps and getting better quality sleep.
During his seventh week of care, he was re-evaluated by his ENT doctor. His ears were clear of fluid with no need for eartubes. He was no longer on the antihistamines and there was no more need for antibiotics.
His chiropractic care continues at a once per week schedule. Follow-up thermal scans reveal a persistent problem in the upper neck that is still being monitored.
Commentary: The authors list several facts supported by references presented in the study. "The most frequent reason for physician visits for children in the United States, under the age of fifteen is otitis media. Acute otitis media is the most common infection for which antibacterial agents are prescribed for children in the United States. In 1990 there were more than 20 million prescriptions for otitis media-related antibacterials prescribed and 25 million visits made to office-based physicians in the United States for this condition. Approximately 10% of infants by 3 months of age will have had an episode of acute otitis media. 50% of children by 3 years of age will have had more than three episodes of acute otitis media. The annual costs associated with the management of pediatric otitis media has been estimated at $5.3 billion.
How much pain and aggravation could be avoided (not to mention money saved) if every child, those with ear infections or not, were checked for spinal subluxations by a chiropractor as soon after birth as possible? Have you had your children checked? It's the best way to ensure they will have every chance to live a healthy life.
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