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One of the downsides to medicine having access to antibiotics, is that all too often we get to use them ... for the wrong reasons! There is also the trend, covered in a previous blog, for patients to ask for a "really strong" antibiotic, instead of asking for the correct antibiotic!
I was reminded of this when reading about a study from California and recently presented at the American College of Allergy, Asthma & Immunology 2011 Annual Scientific Meeting. In a relatively small study of children with a history of allergy, Dr. Nsouli and colleagues compared the effects of an 14 day course of antibiotics - amoxycillin and clauvulinic acid - with a 14 day course of an aqueous nasal spray containing the steroid Ceclosonide.
Their findings revealed that the Spray worked in 8 days, whereas the antibiotics took 14 days!
The problem with middle ear infections in children is a combination of size and obstruction: but it has nothing to do with the ear that we see on the side of the head - which Doctors call the outer ear. That the problem appears to lie within the external appendage is compounded by the fact that Doctors look into the Outer ear, in order to view the eardrum and thus confirm their suspicions of a Middle ear infection, which they do when we see a red ear drum bulging with fluid within the Middle ear.
Now the real reason the fluid is trapped within the Middle ear is because the Eustachian tube, that connects the back of the nose with the Inner ear is blocked - usually by the swollen, inflamed membranes of the nasal passages. But most Doctors don't look up the nose of a child because it's already blocked with yellow/green mucous, and so patients often find it difficult to connect the idea that in order to fix the ear, you have to squirt something "up the nose"!
Dr Nsoulis study is another resource to help convince both patients and Doctors that in the case of middle ear problems, where there is a history of allergy, then inhaled nasal steroids are much the better option than repeated doses of antibiotics which, if truth be known, only lead to increased bacterial resistance of pathogens within the rest of the body: and that's not good medicine for anyone!