In some European countries, antibiotics are used for ear infections only when there is a persistent drainage or persistent pain because these infections resolve on their own more than 85 percent of the time without treatment.1 Studies show that the majority of ear infections are of viral etiology. For example, 75 percent of pediatric ear infections were caused by common respiratory viruses in a microbiological survey.2 Generally speaking, the use of antibiotics should be reserved for serious or life-threatening infections, not conditions that the body is well-equipped to resolve on its own.Adding fuel to the fire, Laurie Tarkan of The New York Times wants to know, are ear infections too often misdiagnosed and then over-treated? Let’s find out:
One reason why ear infections are so often overdiagnosed is that they can be hard to identify in young children, especially ones in screaming pain. “You’re dealing with a tiny subject, the baby or toddler, where the ear canal is narrow and tends to be occluded with wax, which you must remove to see the eardrum, and doing that can be a harrowing experience,” said Dr. Jack Paradise, professor emeritus of pediatrics at the University of Pittsburgh School of Medicine. Doctors then have to interpret what can be subtle differences between an ear inflamed by crying or fever and a true ear infection. “Many if not most practitioners have difficulty in this area,” Dr. Paradise said…This easy way out of ear infections does carry serious risks. Dr. Fuhrman talks about how antibiotics can actually lead to more—not fewer—ear infections. Have a look:
…In 80 to 90 percent of ear infections, the bacterial infection will clear up on its own. Though these bacteria are not typically harmful in and of themselves, clearing up the infection sooner with antibiotics can hasten pain relief. A trade-off is drug side effects like nausea, upset stomach, diarrhea and even rare, life-threatening allergic reactions. “For every case of ear infection that goes away faster, we may cause between three and seven cases of diarrhea,” Dr. Powers said. “We’ve moved the problem from up North to down South.” The use of antibiotics can also increase a child’s susceptibility to new ear infections.
The vicious cycle of poor nutrition and the overuse of antibiotics works to place a tremendous disease burden on the future health of our children. We bring our young (improperly fed) children to physicians with their first ear infection. At this point the majority of these infections are viral, not bacterial. Nevertheless whether it's viral, bacterial, fungal, or some mixture, a healthy child has no problem recovering from an ear infection without antibiotics. In the United States almost all these children are routinely given antibiotics. Taking the antibiotic kills off the beneficial bacteria and promotes the colonization of more disease-causing strains, and now the next ear infection has a greater chance of being bacterial, not viral. Viral, bacterial, or a mixed infection, it matters not, because at the next visit your kid gets another antibiotic anyway, starting the cycle of infection after infection, antibiotic dependency, and impaired immune function.I guess the lesson to be learned here is, don’t mortgage the future for the present—quick-fixes are not without their price tag.
1. Haag M. Essential fatty acids and the brain. Can J Psychiatry 2003;48(3):195-203.
2. Bowman S, Gortmaker S, Ebbeling C, et al. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics 2004;113(1):112-118.