Pediatrics Articles

Antibiotics are not needed for ear infections

by Randall Neustaedter OMD

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Ear infections represent the most common reason for antibiotic prescriptions in children, even though the American Academy of Pediatrics recommends that most children with acute ear infections can be observed for a period of 48 to 72 hours without antibiotics (AAP Subcommittee, 2004). They reached this conclusion because most children with ear infections will get better just doing nothing (Rosenfeld 2003). A study published in the November 2010 issue of JAMA confirms the wisdom of avoiding antibiotics for the treatment of ear infections.

This study reviewed 125 previous studies on the effect of antibiotics vs placebo, and found that 80 percent of children with ear infections would recover within about 3 days without antibiotics. If all of the children were treated with antibiotics, then another 12 percent would improve in three days. However, 3 to 10 percent of the children would develop diarrhea (Coker 2010). The authors could not assess the long term effect of antibiotic treatment on antibiotic resistance and further infections based on the data, but some studies have shown that children treated with antibiotics tend to develop resistance to antibiotics and have more ear infections than children not treated. This makes sense because antibiotics interfere with the production of white blood cells. When white blood cells are unable to fight infections, then recurrence of an infection is more likely (Fratkin).

The modest benefit of using antibiotics for ear infections may be far outweighed by the detrimental effects, especially when other safe and effective treatments exist for resolving these acute infections.

Homeopathy and herbal medicine have been effectively treating ear infections for hundreds, even thousands, of years. A double-blind clinical study of the homeopathic treatment for ear infections showed a significant decrease in symptoms after 24 hours compared with the placebo-treated children (Jacobs 2001). Chinese herbal medicine has especially effective treatment for ear infections in children, including formulas specifically developed for pediatric use (Neustaedter 2010; Fratkin). With these alternatives available and the evidence from numerous studies of antibiotic failure, it seems that the era of prescribing antibiotics for children’s ear infections should be relegated to the past.

References

AAP Subcommittee on Management of Acute Otitis Media, Diagnosis and Management of Acute Otitis Media. Pediatrics 2004 (May) 113(5)1451-1465.

Coker TR, Chan LS, Newberry SJ, Limbos MA, Suttorp MJ, Shekelle PG, Takata GS. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: A systematic review. JAMA. 2010 Nov 17;304(19).

Fratkin J. Pediatric ear infections and Chinese medicine. http://www.drjakefratkin.com/pdf/EarInfection.pdf

Jacobs J, Springer DA, Crothers D. Homeopathic treatment of acute otitis media in children: A preliminary randomized placebo-controlled trial. Pediatric Infectious Disease Journal 2001;20(2):177.

Neustaedter R. The Holistic Baby Guide: Alternative Care for Common Health Problems. 2010, New Harbinger Publications, Oakland, CA.

Rosenfeld RM, Kay D. Natural history of untreated otitis media. In: Rosenfeld RM, Bluestone CD, eds. Evidence-Based Otitis Media. 2nd ed. Hamilton, ON, Canada: BC Decker Inc; 2003:180–198.

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