Antibiotics Overused For Ear Infections?

(CBS)  More than five million children are diagnosed with ear infections every year. But in many cases the usual prescription of an antibiotic is proving to be unnecessary and overdone.

Dr. Owen Hendley, professor of pediatric infectious diseases at the University Of Virginia, recently published a scholarly review in The New England Journal Of Medicine that says antibiotics are not always the answer for treating an ear infection.

Dr. Hendley explained on The Early Show that ear infections are always accompanied by a cold, common in young children. "The cold alters the function of the tube that leads from the back of the nose into the ear. And because that tube isn't working right, then bacteria may be trapped in the ear and cause what's termed a secondary bacterial infection, which would be useful to have antibiotics for that," he explained.

However, the problem is that there is no way to determine if there is bacteria in the ear or not.

"The cold itself may alter the ear so that it's often very difficult to tell whether an antibiotic would be helpful for not," he said. This leads to doctors over prescribing antibiotics, just in case there is an ear infection. So what is the danger in that?

"Well, the antibiotics that are used for ear infections or strep throats or whatever, remember they don't just attack the organism that's causing the infection. They also alter the flora in our alimentary tract which goes from the tip of the tongue all the way out. So the bacteria get a chance to see the antibiotics, and then the ones that are sensitive are killed, and the ones that are not sensitive are selected and get a chance to overgrow. And this process has been going on ever since we've had antibiotics and it is very scary how smart these organisms are when we give them antibiotics to play with," Dr. Hendley said.

Therefore, Americans are becoming more and more de-sensitized to the effects of antibiotics because they have been overmedicated on these drugs. Thus, when they are infected with bacterium, the amoxicillin, penecillin etc. are ineffective.

Dr. Hendley recommends that doctors hold off giving antibiotics for 48 to 72 hours to see whether the infection clears up spontaneously. He urges that doctors avoid the over-prescription of antibiotics.

In the Oct. 10 edition of the New England Journal of Medicine, Dr. Owen Hendley writes that placebo-controlled trials found that ear infections disappeared in one week in 81 percent of placebo recipients, compared with 94 percent of antibiotic recipients.

Thus only 1 in 8 children needs antibiotics to treat his/her ear infection.
In the past, antibiotics would have been prescribed for all eight.

Dr. Hendley's also points out in the study that children are all too often getting tubes in their ears or typanostomy tubes, which help drain fluid from the middle ear.

Typically children with recurrent ear infections, usually three or four episodes within six months, are urged to get the tubes. Dr. Hendley says there is no benefit to children unless they suffer from more severe bacterial otitis. Often, he says, the fluid goes away on its own.

And as for giving the child a flu shot, he says it will reduce the likelihood of ear infections by 30 percent, but the benefit only lasts through the flu season of approximately six weeks.

Here is how you can tell if a child has an ear infection:

• Unusual irritability
  
• Difficulty sleeping
  
• Tugging or pulling on one or both ears
  
• Fever
  
• Fluid draining from the ears
  
• Loss of balance
  
• Unresponsiveness to quiet sounds or other signs of hearing difficulty.

The effects of an ear infection, if not treated, can cause severe pain and serious hearing complications, including hearing loss, and speech and language disabilities, Dr. Hendley said.