Ear Infections and Management Strategies

ATTENTION to all parents who have kids suffering from ear infections that are frequently prescribed antibiotics…
 
Ear infections, medically known as acute otitis media is one of the most frequently diagnosed diseases in children and more than 20 million antibiotics are prescribed annually in the United States.[1],[2]
 
Otitis media with effusion (OME) is when there is fluid in the middle ear without signs or symptoms of ear infection.[3]  
Acute otitis media (AOM) is when there is the presence of fluid in the middle ear in conjunction with recent or abrupt onset of signs of inflammation of the middle ear.[4]

Frequently, AOM is over diagnosed,[5] and failure to differentiate AOM from OME may be the most common cause of unnecessary antibiotic prescriptions3 and may contribute to antibiotic-resistance.  AOM and OME both are upper respiratory tract infections, but children with AOM also have pain and fever.

The current recommendation for the treatment of AOM is to use an antibacterial agent (usually amoxicillin).[6] Antimicrobial therapy is not recommended for patients with OME because it typically resolves spontaneously. [7]

A literature review that looked at results from forty-nine articles concluded that it is possible that some children with AOM may benefit from spinal manipulation therapy or spinal manipulation therapy combined with other therapies. However, more rigorous studies are needed to provide evidence and a clearer picture for both practitioner and patients. [8]
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So if you’d like to know more about if we may be able to help in the management of recurring ear infections along side your Medical Doctor, please give our Practice a call.

References
[1] American Academy of Family Physicians, & American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. (2004). Otitis media with effusion. Pediatrics, 113(5), 1412-1429.

[2] American Academy of Pediatrics Subcommittee on Man- agement of Acute Otitis Media. Diagnosis and manage- ment of acute otitis media. Pediatrics 2004;113:1451-65.

[3] Steinbach, W. J., & Sectish, T. C. (2002). Pediatric resident training in the diagnosis and treatment of acute otitis media. Pediatrics, 109(3), 404-408.

[5] Pichichero, M. E., & Poole, M. D. (2001). Assessing diagnostic accuracy and tympanocentesis skills in the management of otitis media. Archives of pediatrics & adolescent medicine, 155(10), 1137-1142.

[6] Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics 2004;113:1451-65.

[7] Dowell SF, Schwartz B, Phillips WR. Appropriate use of antibiotics for URIs in children: part I. Otitis media and acute sinusitis. The Pediatric URI Consensus Team. Am Fam Physician 1998;58:1113-8, 1123.

[8] Pohlman, K. A., & Holton-Brown, M. S. (2012). Otitis media and spinal manipulative therapy: a literature review. Journal of chiropractic medicine, 11(3), 160-169.