ear infectionsTreating acute otitis media (inner ear inflammation or ear infections) with antibiotics is rarely required to improve patient outcome and likely adds to the growing burden caused by antibiotic resistant organisms. Still, acute otitis media (ear infections or inner ear inflammation) is the most common reason that antibiotics are prescribed for children. The watch and wait method (treating pain and fever only) often requires more discussion with nervous parents who feel the need to do what their parents did for them; give an antibiotic. Perhaps there is a way to limit antibiotic use while empowering parents at the same time. In the September 13th issue of JAMA a randomized control trial was published showing that the "wait and see" prescription method will result in less antibiotic consumption, without a decrease in patient care. Emergency room visits for otitis media (ear infections or inner ear inflammation) were randomized to one of two prescriptions; a "standard prescription" in which the parents were told to fill the antibiotic prescription immediately or a "wait and see prescription" in which the parents were instructed not to fill the prescription unless the child did not improve within 48 hours (these prescriptions expired after 3 days). Both groups were given ibuprofen suspension and otic analgesic drops. Outcomes measured included prescription fill rate between the two groups as well as the course of illness, adverse events of medications and related measures. The standard prescription was filled by 87% of parents while the "wait and see" prescription was filled by only 38% of parents. For children under 2, the rates were 95% and 53% respectively. Disease outcomes between the two groups were similar; however, diarrhea was 3 times more frequent in the "standard prescription" group than the "wait and see" group. More importantly; the confidence in withholding antibiotics for future episodes was more than doubled in those "wait and see" parents who did not fill the prescription. This is an important report because it shows a successful way to begin limiting the use of antibiotics in children, without reducing the parent's ability to choose care for their children. Parents and physicians should always use discretion when giving antibiotics to children, and always suggest the use of an adequate probiotic supplement to reduce the likelihood of antibiotic associated diarrhea. Click here for full article including references. For information on some of these foods that cause ear infections click here. For help with your ear infections call Monica Levin at 248-656-2505 for an appointment in Wixom, Michigan. For an evaluation of food allergies you can also have an online appointment. Note: Monica Levin has allergy-free cookbooks for sale. |
