LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Ear Infections

Otitis Media Guidelines May Not Be Affecting US Physician Habits – (10-23-00)

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Otitis Media Guidelines May Not Be Affecting US Physician Habits

For the past 20 years, research has indicated that antibiotics should not be used for childhood ear infections, and the past 5 or 6 years the recommendations have been strong to avoid antibiotics. And yet the doctors are not getting the message. Does this suggest that they are not getting the info? That is sort of scary…part of being a physician is staying on top of recent developments to improve the efficacy and safety of your practice.

(article) Federal guidelines for treating otitis media with effusion in children may not be making their way into US physicians’ practices, according to survey results released here at the annual meeting of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The guidelines were published by the Agency for Health Care Quality and research, now known as the Agency for Healthcare research and Quality (AHRQ), in 1994, to what survey author Dr. Michael G. Stewart called a “warm reception” among pediatricians and otolaryngologists. But the survey of nearly 600 such physicians shows that many are either unaware of the guidelines or unwilling to use them. “It’s very clear that it’s not enough to produce a guideline and just put it out there. Many studies show this with many guidelines, that if you can’t implement them with a concerted educational effort at the clinical level that they will have no effect.” AHRQ now has an initiative called Translating research into Practice, designed to find ways to increase the effectiveness of guidelines.

Evidence Assessment of Management of Acute Otitis Media – (08-13-01)

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Evidence Assessment of Management of Acute Otitis Media

I’m not going to go into this in more detail, but I do want to once again stress that antibiotic resistance is really only a minor complication of antibiotic miss use.  Consider the long term chronic effects that destroying the normal flora has on overall health. Alterations in the GI tract can lead to a host of quality of life-destroying illness, potentially including allergies, asthma, Crohn’s disease, rheumatoid arthritis and most all autoimmune conditions. Consider that next time you’re given an antibiotic for a condition that will clear up just as quickly without it.

Pediatrics — Abstracts: Takata et al. 108 (2): 239

Read entire article here

Childhood Ear Infections: ”Wait-and-See” Approach May Be Best – (08-30-02)

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Childhood Ear Infections: ”Wait-and-See” Approach May Be Best

Otitis media with effusion (OME), more commonly known as fluid in the middle ears, is a common childhood condition. It is estimated that more than 2 million cases of OME are diagnosed in the U.S. each year. OME does not involve any type of infection or inflammation to the ears and usually clears up on its own, without treatment, but that doesn’t stop many pediatricians from prescribing antibiotics on a regular basis.

The American Academy of Pediatrics recently issued a new series of guidelines for diagnosis and treatment of OME in children ages 2 months through 12 years. The guidelines recommend that children with OME should be managed with “watchful waiting” for at least three months before recommending other treatment.

After three months, children should be re-examined at three- to six-month intervals until: a) the fluid is no longer present, b) significant hearing loss is identified, or c) the practitioner suspects the child has a structural abnormality in the eardrum or middle ear. The guidelines are not intended to be the “sole source of guidance,” but rather a tool to assist health care providers, including doctors of chiropractic.If your child suffers from ear infections, make sure he or she receives a comprehensive evaluation before antibiotics are prescribed.

To learn more about common childhood conditions click here.

Reference: Academy of Pediatrics. Otitis media with effusion. Clinical practice guideline. Pediatrics May 2004;113(5):1412-29.

 

Effect of conjugate pneumococcal vaccine – (07-14-03)

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Effect of conjugate pneumococcal vaccine followed by polysaccharide pneumococcal vaccine on recurrent acute otitis media

I realize that ear infections in infants and toddlers are about as common place as dirty diapers, but I feel that we are managing this condition completely wrong. Instead of recommending lifestyle changes such as common allergen avoidance (dairy, corn, wheat, soy) we are trying hard to come up with a vaccine. Also, antibiotic use destroys normal flora, and this destruction appears to change the flora in a negative way and predispose to further infection. This is despite the fact that antibiotics have very little impact on the course of the infection.

Read entire article here

Use of antibiotics contributes to recurring ear infections – (05-13-04)

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Effect of recolonisation with “interfering” alpha streptococci on recurrences of acute and secretory otitis media in children

No one wants to quite come out and say it, but evidence strongly points towards antibiotic use as a contributing factor to recurrent ear infections. Antibiotics will destroy the normal bacterial flora that prevents other, pathogenic bacteria from being able to grow and thrive. All of this in light of the fact that antibiotics don’t even have much of an ability to shorten duration of an ear infection.

Entrez PubMed –

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Antibiotics in Children Destroy Immune System, Leads to IBD

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The buzz around overuse of antibiotics focuses on antibiotic resistance, but the danger lies in destruction of the normal, protective flora and immune balance.

For decades now, researchers have been figuratively screaming at clinicians to stop the antibiotic overuse.  These voices largely seem to fall on deaf ears as antibiotics are still used routinely for things like viral infections, upper respiratory tract infections and routine dental work.  Many doctors and parents are hesitant to use a watchful waiting period instead of antibiotics.

Maybe the use of antibiotics remains so pervasive before prescribing doctors do not really understand the relationship between a healthy bacterial flora in an infant and child’s gut and the delicate balance of their immune system.

We have seen , by the time they hit 32 months, have received antibiotics.  This is frankly, appalling.  My son Keegan received his only course of antibiotics at about 5 1/2 years old, which was, of course, followed up by a course of probiotics.

The relationship between the bacteria in our gut and the healthy development of the immune system has been demonstrated time and time again for over a decade.  Any lack of understanding of this relationship, at this stage of the research, is unforgivable.

Some examples include:

  1. 2004-Lactobacillus calms inflammation in the joints.
  2. 2004 – using gut bacteria to prevent colitis.
  3. 2004 – bacteria in the gut can affect the dendritic cells, a key immune regulator.
  4. 2005 – healthy bacteria led to less allergies, bad bacteria led to more.

There are many more, but you can get the idea that this concept is nothing new.

One of the scariest aspects of overuse of antibiotics, though, is the potential to increase the risk of inflammatory bowel disease like Crohn’s disease or ulcerative colitis.

These are potentially devastating autoimmune conditions of the gut that lead your body’s immune system to attack itself.  In bad cases, large sections of the small intestine or colon need to be removed.  It can be debilitating.

And it’s happening to our kids.  This is not a condition any child should have to deal with.  But they are.  And you can bet that rampant use of antibiotics is playing a very large role.

This particular study looks at just how strong the link between antibiotic use as a child and inflammatory bowel disease is.  And it’s much stronger than anyone would’ve thought:

  1. The rate of developing IBD in children who had been given antibiotics was 84% higher.
  2. Any use of antibiotics during childhood increased the risk, but this declined as the child got older.
  3. Use before 1 year of age increased the risk a massive 551%.
  4. Use between age 1 and 5 increased the risk 262%.
  5. Use between 5 and 15 years increased the risk 157%.
  6. Each use of antibiotics increased the overall risk of developing IBD 6%.
  7. The more doses the worse, with >2 antibiotic courses increasing the risk 477%.

These are some VERY serious numbers.  Let me reiterate again that inflammatory bowel disease like Crohn’s disease and ulcerative colitis can be devastating conditions.

Put this into perspective the next time your pediatrician recommends antibiotics for your 6 month old’s ear infection instead of avoiding dairy and adding probiotics.  It’s that clear cut.

Better yet, if your child’s pediatrician is recommending antibiotics when not absolutely, positively necessary, ask what the potential long term risks are of a single course of antibiotics.  If they give you a blank stare, it’s time to find a new one…

How old was your child when he or she had his or her first course of antibiotics?

 

PROBIOTIC SUPPLEMENTATION AND DAIRY AVOIDANCE TO PREVENT EAR INFECTION – (09-24-03)

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Osteopathic Manipulation as Adjuvant Therapy in Children with Recurrent Acute Otitis Media

While I love to see articles such as this (the findings not really a big surprise to any chiropractor), it is unfortunate that any press this article receives will not extend to chiropractic. Heck–why should it? Just because DCs perform 90% of manipulations and DOs have manipulation as an elective?? Oh well. Remember to add probiotic supplementation and avoidance of dairy to manipulation and just about every ear infection should become history.

Arch Pediatr Adolesc Med — Abstracts: Mills et al. 157 (9): 861.

Read entire article here