Is antibiotics effective in the treatment of middle ear infection ?
(By: Dr. Chantell Groenewald M.Tech Hom (UJ), Studio.Homoeopathy)
Otitis Media is most commonly caused by either a viral or bacterial infection of the middle ear (the space behind the eardrum). The infection may result from a cold or flu, which causes swelling and congestion of the eustachian tubes (the narrow tube that connects the middle ear to the throat). The swelling and congestion in the eustachian tube causes the accumulation of fluid behind the eardrum and it is the infection of this fluid, which causes the symptoms of middle ear infection.
Signs and Symptoms:
- Ear pain, especially when lying down
- Tugging or pulling at an ear
- Difficulty sleeping
- Crying more than usual
- Acting more irritable than usual
- Difficulty hearing or responding to sounds
- Loss of balance
- Fever of 100 F (38 C) or higher
- Drainage of fluid from the ear
- Loss of appetite
Until recently, antibiotics was the most commonly prescribed treatment for middle ear infection in children. However, the efficacy of antibiotics in the treatment of acute otitis media (AOM) is being questioned, with more and more evidence suggesting that antibiotics is in fact, of little value.
In an article published in Paediatric and Preinatal Drug Therapy (Vol.4 , Issue 2, 2000), Dr. Damoiseaux (GP) concluded, children between 6-24 months should be managed by watchful waiting, as antibiotics seems to have little effect on the symptoms at this stage. Furthermore he stressed the importance of symptomatic treatment in relieving the child’s discomfort.
Another article in The British Journal of General Practice (Br J Gen Prac. 1998) compared antibiotic treatment with non-antibiotic treatment in acute otitis media in children aged under two years using a systematic literature review and a quantitative analysis with an assessment of the methodological quality of published trials. Their conclusion was that the high prescription of antibiotics in children under two years of age in the treatment of middle ear infection is not sufficiently supported by evidence from published trials.
Symptomatic treatment of AOM (middle ear infection):
Homeopathy plays a great role in the symptomatic treatment of AOM. A Remedy is chosen based on matching the child’s symptom picture to the remedy symptom pictures, some common middle ear infection remedies include:
- Aconite: Rapid onset of attack, high fever, sharp pains with bright red ears
- Belladonna: Sudden onset of violent pain and high fever, inflamed right ear, worse 3pm.
- Chamomilla: Otitis during teething. Ears red and hot, violent pain which makes the child irritable, child wants to be held.
- Ferrum phos: First stage, before exudation, throbbing pain, membrane red and bulging.
- Pulsatilla: Otitis with every cold. Copious thick, yellow-green discharge.
- Silica: Chronic discharge from repeated infection.
Treatment is further aimed at building up the immune system to allow the body to heal itself. Also of vital importance is treating the gut, often previous antibiotics leaves the gut devoid of the good bacteria, which in itself can cause inflammation and poor immune function.
There is a time and a place for antibiotic treatment in AOM in infants and babies up to two years of age, especially in infants less than 6 months, or high risk cases, however, 6months- 2years, watchful waiting and symptomatic treatment is the most commonly accepted treatment plan. Children older than two years, there seems to be very little evidence to support treating AOM with antibiotics in children older than 2 years of age. Homeopathy offers an alternative especially for symptomatic treatment of AOM.
Damoiseaux, R. (2000), Antibiotics for Acute Otitis Media in Infancy: Based on fears or facts? Peadiatric and Prerinatal Drug therapy, Vol 4, Is 2, pp 58-60
Damoiseaux, R., van Balen, F., Hoes, A., de Melker, R. (1998), Antibiotic treatment of Acute Otitis Media in children under two years of age: Evidence Based? The Brittish Journal of General Practice, 48(437), pp 1861-1864
Mayo Clinic (2014), Ear infection (middle ear). Available from: http://www.mayoclinic.org/diseases-conditions/ear-infections/basics/treatment/con-20014260