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Ear Infections: New Thinking on What to Do

Rating

3 Star

Ear Infections: New Thinking on What to Do

Our Review Summary

 The story did a good job of explaining that many ear infections will clear up on their own and that overuse of antibiotics can cause problems. However, it should have done more to answer the questions that many parents will probably have about this issue, including whether the "observation option" discussed in the story leads to a slower recovery or increases the risk of a more serious infection. Finally, the story should have explored why it is important to try to prevent the spread of drug-resistant bacteria. 

 

Why This Matters


Ear infections often will clear up without the use of antibiotics, but children must be monitored carefully to make sure the infection doesn’t worsen and cause potentially serious complications. Educating consumers about this balance can help assure appropriate care for kids with ear infections while also prolonging the effectiveness of our existing stable of antibiotics.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Providing early antibiotics vs. observation is an issue with cost implications for patients and the health care system. The story doesn’t mention costs.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story states that the primary benefit of delaying antibiotic treatment is to prevent resistance to antibiotics. This is true, but the story provides no specifics regarding the scope or expected magnitude of this benefit. The story should have provided at least some reference to what can happen to us individually, and as a society, when microbes develop antibiotic resistance.  It also could have mentioned that antibiotics can have adverse effects that might be avoided through observation instead of early treatment.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory
Although the article states clearly that children with ear infections need to be monitored closely, it should have mentioned what can happen when an untreated ear infection does not resolve on its own and the parent fails to bring the child back to the doctor’s office for follow-up. The infection can spread to the mastoid bone causing potentially serious and irreversible neurologic complications.    Indeed, this is why pediatricians have been reluctant not to treat.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory
Since the story is headlined "New Thinking About What To Do" for ear infections, and since it is clearly based on American Academy of Pediatrics guidelines from 2004, readers are left wondering "why now?" and "what’s new?" Besides mentioning the guidelines, the story is devoid of "evidence."

Does the story commit disease-mongering?

Satisfactory

The story does not exaggerate the prevalence or severity of ear infections.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story quotes two experts who don’t appear to have financial conflicts regarding the subject matter in the article.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story notes that doctors used to give antibiotics immediately upon making an ear infection diagnosis. It states that this practice is changing due to research showing that most untreated ear infections will clear up on their own.

In addition to the issue of early antibiotics vs. observation, there is also the question of which antibiotic to use. The increased use of broad-spectrum antibiotics as first line agents is likely to aggravate issues with bacterial resistance. This could have been mentioned.The article also could have mentioned the variety of alternative and home remedies that are used for the treatment of ear infections, but in all likelihood these treatments would have little if any evidence to support them—so this omission is acceptable.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The widespread use of antibiotics is clear from the one expert’s quote: "Until eight or nine years ago, we’d treat each ear infection at diagnosis."

Does the story establish the true novelty of the approach?

Satisfactory
Although the headline verges on the deceptive when it states that there is “new” thinking on what to do for ear infections, the text accurately states that the observation option came into widespread use roughly within the past decade and was promoted in the 2004 American Academy of Pediatrics guidelines. This is a borderline satisfactory. 

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to be based on any news release that we could identify.

Total Score: 6 of 10 Satisfactory

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