Well­ness Arti­cles

Antibi­otics Not Needed for Most Ear Infec­tions

A study pub­lished in the Sep­tem­ber 13, 2006 Jour­nal of the Amer­i­can Med­ical Asso­ci­a­tion (JAMA) shows that “watch­ful wait­ing” is bet­ter than using antibi­otics for the treat­ment of ear infec­tions known as Acute Oti­tis Media (AOM). The study starts off by not­ing that AOM is the most com­mon diag­no­sis for which antibi­otics are pre­scribed to children.

In this study 283 chil­dren ages 6 months to 12 years seen in a hos­pi­tal emer­gency depart­ment, with acute ear infec­tions were divided into two groups. One group was treated only by the “wait-​and-​see pre­scrip­tion”, known as the WASP group. The sec­ond group was known as the SP group which stood for “stan­dard pre­scrip­tion”. The authors noted that pre­vi­ous stud­ies did not include severe cases as would be seen in the emer­gency room as with these cases.

The “wait-​and-​see pre­scrip­tion” group of chil­dren did get a pre­scrip­tion for antibi­otics, but their par­ents were advised to wait and see for 48 hours before con­sid­er­ing fill­ing the pre­scrip­tion. These par­ents were asked not to fill the pre­scrip­tion they were given unless the child either is no bet­ter or is worse in 48 hours. The “stan­dard pre­scrip­tion” group got a pre­scrip­tion for antibi­otics and were not given any instruc­tions to wait and see.

The results showed that 62% of the pre­scrip­tions in the WASP group were never filled. Con­versely, about 90% of the chil­dren in the “stan­dard pre­scrip­tion” group whose par­ents were not asked to wait and see wound up tak­ing the antibi­otics. Even more inter­est­ing is that the researchers found that, “There was no sta­tis­ti­cally sig­nif­i­cant dif­fer­ence between the groups in the fre­quency of sub­se­quent fever, otal­gia (pain), or unsched­uled vis­its for med­ical care.” In essence the group that did not take antibi­otics did just as good as the group that took the medication.

Lead researcher, David M. Spiro, MD, com­mented in a WebMD arti­cle by say­ing, “In this coun­try, 96% to 98% of physi­cians treat ear infec­tions imme­di­ately with antibi­otics, even though most cases will resolve on their own with­out treat­ment.” In the con­clu­sion of the study, Spiro and co-​authors stated, “The WASP (wait-​and-​see-​prescription) approach sub­stan­tially reduced unnec­es­sary use of antibi­otics in chil­dren with AOM (acute oti­tis media) seen in an emer­gency depart­ment and may be an alter­na­tive to rou­tine use of antimi­cro­bials for treat­ment of such children.

It should be noted that in 2004 the Amer­i­can Acad­emy of Pedi­atrics gave their approval to the wait-​and-​see approach and stated that 80% of chil­dren whose ear infec­tions are not treated imme­di­ately with antibi­otics get bet­ter on their own.

Ran­dom Article

A study pub­lished in the Octo­ber 11, 2004 issue of the Archives of Inter­nal Med­i­cine showed that includ­ing chi­ro­prac­tic care into health plans

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