Corticosteroids Instead?

Parents should think twice before administering antihistamines to relieve their child's symptoms during their next ear infection.
Remedy increases recovery time
A new study by researchers at the University of Texas Medical Branch at Galveston, published today in the Journal of Pediatrics, says this common remedy not only increases recovery time but could lead to more problems.

The standard treatment for ear infections has been antibiotics. However, Dr Tasnee Chonmaitree, UTMB professor of pediatrics and pathology, says that some doctors stay away from prescribing antibiotics for ear infections to avoid building resistance. Since many children with acute ear infections have cold symptoms caused by a virus, these same doctors recommend an antihistamine and/or a decongestant to relieve symptoms.

Bacteria and viruses may increase the degree of inflammation in the ear by producing more histamine and other inflammatory substances. For that reason, UTMB researchers tested their theory that the use of an antihistamine or a corticosteroid -- which is given to tamp down the immune system's response and thus reduce inflammation -- would fight off the infections better. The UTMB study included 179 children with acute ear infections who were treated with antibiotics. The children were divided into four different groups to receive antihistamines, corticosteroids, both drugs in tandem, or neither and a placebo in their place.

Corticosteroids the answer?
"We expected that patients who received either the antihistamine or corticosteroid, in addition to the antibiotic, would have clearing symptoms and less recurrence," says Chonmaitree. Instead, Chonmaitree and her team found that corticosteroids helped. In fact, she said the children who received corticosteroids had no change and those who received antihistamines maintained fluid in their ears longer.

That fluid can have serious consequences, she noted: "Prolonged presence of fluid in the middle ear can impair hearing, promote recurrence of infection and can lead more serious situations such as ear tube replacement."

Ear infections are one of the most common diseases in infants and young children and result in more than 30 million visits to physicians annually, Chonmaitree says.


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