Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: FRIDAY, July 15, 1994 TAG: 9407150071
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
SOURCE: Associated Press
DATELINE: WASHINGTON LENGTH: Medium
The directive ``should be good news to parents,'' said Dr. Philip R. Lee, director of the U.S. Public Health Service, because the condition leads between 6 million and 8 million children to visit doctors' offices annually.
In the past, the condition was treated with antibiotics initially and, in prolonged cases, with surgery that involved implanting plastic drains.
But Lee said health officials now think doctors and parents should first give nature a chance.
The guidelines recommend treatment for otitis media with effusion, a condition in children ages 1 to 3 in which fluid accumulates inside the ear drum, muffling hearing. The condition, sometimes called ``glue ear,'' has no symptoms other than the fluid collection. There is no ache or fever as with acute otitis media, the ear infection that can cause severe pain.
Otitis media with effusion, or OME, if allowed to continue for many months, can reduce hearing acuity at a time when children are learning to speak. For this reason, the condition has often been treated aggressively.
But Dr. Alfred Berg, a co-chairman of a federal panel of experts and a professor at the University of Washington, said that in most cases, OME disappears within three to six months without medical treatment.
``This fact ... gives weight to the use of observation or watchful waiting as an acceptable way to manage [the disorder] within the first three months,'' he said.
Berg said antibiotics are of very limited value in treating OME. He said the panel concluded that antibiotics, at best, conferred only a 14 percent advantage over doing nothing. Also, said Berg, antibiotics can cause side effects and lead to the development of drug-resistant bacteria that can cause a more serious disease.
``Antibiotics are a valid option for treating OME, but they are not ... the preferred option in early stages of the condition,'' Berg said.
If OME persists after three months of ``watchful waiting,'' the new guidelines say children should be given hearing tests. If the tests show normal hearing, observation or antibiotics are appropriate.
In cases of hearing loss after three months, the guidelines call for a choice between antibiotics or surgery. Should the condition continue for four to six months, with hearing loss, the preferred treatment is surgery, he said.
by CNB