Children's Wellness: Ear infections and antibiotics; An antiquated paradigm

Children's Wellness: Ear infections and antibiotics; An antiquated paradigm

Most people think that childhood and ear infections are inseparable and unavoidable. The truth is that although common, ear infections are not a normal part of childhood.

Yet, today, the public is more confused than ever about how to "treat" the condition. They receive contradictory information from TV, magazines, pediatricians, pharmacists, health food stores, and chiropractors.

Let's review the facts.

A common cause of otitis media is a viral cold. Antibiotics, although they are the most common treatment prescribed for otitis media, don't react to viruses. Thus, each year, millions of antibiotic prescriptions are mistakenly prescribed to children. To compound the problem, parents don't realize that each time an antibiotic is taken, some of the bacteria die leaving the resistant strain to grow and multiply.

As the number of drug-resistant ear infections rises, many doctors have concerns that amoxicillin is losing its effectiveness. The more antibiotics prescribed, the greater the rate of resistant bacteria potentially able to infect a child.

Drug resistance has become a major problem, with whole wings of hospitals devoted to this condition.

According to Scott Dowell, a medical epidemiologist at the Respiratory Diseases Branch of the Center for Disease Control (CDC), overtreatment of ear infections has been a big contributor. About one third of ear infections are asymptomatic and happen to get diagnosed during well baby checkups. "One of the important steps in using antibiotics more wisely is not to treat those kids," Dowell said.

For several years, Stu and I have stated that the "well baby check-up" is among the most dangerous trips to the pediatrician a parent could ever make. Under the guise of weighing and measuring the child, parents subscribe to bringing their children into the doctor's office.

This so-called "well visit" is the time the pediatrician will inject your healthy child with potentially damaging vaccinations, prescribe antibiotics, and give other harmful medications to otherwise healthy children. While parents commonly walk in with a well child, they walk out with several prescriptions -- and a great deal of confusion.

An estimated 24-30 million visits are made each year to doctors due to ear infections, which in 1990 was the second most common diagnosis among all age groups in the United States. Unfortunately, doctors are now "prescribing" to the theory that more is better.

Not only do pediatricians still believe that amoxicillan should remain the first choice of treatment, now they are saying that children should receive twice the current dosage. Although they claim the higher dosage does not appear to cause more or worse side effects, it can still cause stomachaches, diarrhea and allergic reactions like the regular dosage.

In the January 28, 1999 issue of the New England Journal of Medicine, the article "Prevalence of Various Respiratory Viruses in the Middle Ear During Acute Otitis Media," made some important points.

- Point 1: Acute otitis media is the most common bacterial infection among children and the most frequent reason for outpatient antibiotic therapy. Despite this treatment, the middle ear effusion may persist for weeks or months. The result is repeated doses of antibiotics and eventually surgery.

- Point 2: The cost of treatment for acute otitis media has been estimated to exceed $3.5 billion annually.

- Point 3: Although otitis media is generally considered a bacterial infection, there is ample evidence that respiratory viruses have a crucial role in the etiology and pathogenesis of this disease.

As previously stated, antibiotics are only effective against treating bacteria, and are ineffective against viral infections. Still, according to the CDC and the National Center for Health Statistics, incredibly 3,000,000 prescriptions are written for ear infections annually -- 30% (900,000) of which are unnecessary!

The Journal of the American Medical Association (JAMA) has stated that "Amoxicillin is not effective in the treatment of persistent asymptotic middle ear infections." JAMA additionally stated, "Children who took the drug for chronic ear infections were two to six times more likely to have a recurrence than those who received a placebo or sugar pill."

These days, drug companies are more desperate than ever to expand their business. A prime example is Pfizer's "Zoo Day to the Max." According to PRNewswire, this is a celebration devoted to children's "health," featuring entertainment for children and adults.

Pfizer has the event planned for several cities across the country to focus on children's ear infections and provide information about the oral antibiotic Zithromax (azithromycin for oral suspension) to groups most directly involved-community groups and physicians. Zithromax is symbolized by a mascot, a zebra character "Max," who will be in attendance.

The thought of children and parents being exposed to this sort of manipulation is appalling. Naming a character after an antibiotic, having children come, meet, and talk to "Max" the Zithromax mascot, is insulting to our intelligence. Such mixed and contradictory messages being taught to our nations youth is stifling.

Children are constantly being barraged with messages of "Just Say No To Drugs," and "Drugs Don't Work," yet at the same time they're brought to the zoo to celebrate taking an antibiotic with a drug company!

We need to encourage our patients and the public to become informed, and make educated decisions regarding their children's health. The truthful message is that -- whether pushed or prescribed -- drugs kill.

"Zoo Day To The Max," is the perfect example of why you need to take a stand and become a leader in your community. It's up to all of us to teach our communities what true health is all about. Each of us must become involved!

Join the World Children's Wellness Foundation and support national public awareness campaigns for chiropractic and children. Participate in Kids Day America/International and make a significant and lasting impact on your community. Only by taking action together will we make the profoundly positive impact necessary to change the world.

Please join us in our quest. The children of the world need you.

The Chiropractic Journal.


By Theresa Warner

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