Ear :: Treatment guidelines for ear infections

Researchers at Children?s Hospital of Pittsburgh of UPMC have launched a major National Institutes of Health-funded study to develop definitive treatment guidelines for the most common pediatric illness ? ear infections.

Ear infections are the most common illness in children for which antibiotics are prescribed, and at least three out of four children will have one or more ear infections by age 3, according to the study?s principal investigator, Alejandro Hoberman, MD, chief of the Division of General Academic Pediatrics at Children?s.

Dr. Hoberman and colleagues are conducting a randomized, placebo-controlled study of the efficacy of antibiotics in children with middle ear infections, also known as acute otitis media (AOM).

Children?s will enroll 268 children ages 6 ? 23 months with AOM in this study, which is funded through a two-year, $1.8 million grant from the National Institute of Allergy and Infectious Diseases, one of the National Institutes of Health.

This carefully designed study will help pediatricians evaluate whether antimicrobial treatment along with analgesic treatment (for pain relief) offers young children with AOM an earlier and more complete overall clinical improvement than analgesic treatment alone. ?A watchful waiting approach recently has been endorsed by the American Academy of Pediatrics, mostly due to concerns about over-prescribing antibiotics and antibiotic resistance,? said Dr. Hoberman, recipient of the Jack L. Paradise Endowed Chair in Pediatric Research at Children?s and a professor of Pediatrics at the University of Pittsburgh School of Medicine. ?Our large, randomized study will provide definitive answers on whether antibiotics help children recover sooner and with less discomfort than with watchful waiting.?

Dr. Hoberman?s AOM-related research has included the evaluation of antibiotics in treatment regimens; the evaluation of topical otic analgesic medication; the evaluation of the seasonality of antibiotic resistance; and the efficacy of influenza vaccine in preventing AOM in young children.

He also has been a national leader in efforts to improve the diagnosis of AOM. Together with Children?s pediatrician Phillip H. Kaleida, MD, he developed a multimedia educational series of otoendoscopic examinations for self-training by medical residents. A second multimedia program had the objective of education medical students on the differences between AOM and otitis media with effusion.

Additionally, Drs. Hoberman and Kaleida developed an innovative program known as ePROM (enhancing Proficiency in Otitis Media) with funding from the Centers for Disease Control and Prevention and the Association of American Medical Colleges. This program includes Web-based interactive modules; individualized telemedicine feedback; and reinforcement of skill by training champions at each residency program.

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