Conflict of interest taints antibiotic research

Antibiotics may not be the best way to treat ear infections.This double-blind study from the University of Pittsburgh found that children treated with amoxicillin didn't recover any faster than children treated with a placebo, and were even more likely to have their infections recur.

These results contradict a 1987 analysis of the same data, which appeared in the New England Journal of Medicine and supported amoxicillin treatment. The Journal of the American Medical Association decided to publish this alternative report after reviewing evidence showing (1) that the authors of the original report omitted data that did not support amoxicillin, (2) that amoxicillin's manufacturer paid $260,000 in honoraria to the scientist responsible for the pro-amoxicillin report, and (3) that the manufacturer paid $3.5 million in research grants to the research center where the study was performed. - E. I. Cantekin et al., "Antimicrobial therapy for otitis media with effusion ('secretory' otitis media)," Journal of the American Medical Association 266 (Dec. 18, 1991): 3309-17. See editorial comments on pages 3333-34 of the same issue.

Concern grows over insertion of tubes to fight ear infection

From the New York Times: The most common operation being performed on children today is the insertion of tubes into the ears to combat the effects of middle ear infection. There is now growing concern over its effectiveness and controversy about when it is appropriate with few good studies to support either side.

Dr. Jack L. Paradise, a pediatrician at the University of Pittsburgh School of Medicine states, "Far too many children are getting tubes - for every one child who needs and gets tubes, about 20 others who don't need them also get them. They nearly always cause permanent scars on the eardrum and could impair hearing decades later." Dr. Paradise also states the evidence is extremely weak that the persistent fluid in the ears can cause lasting handicaps. The studies are inconclusive, yet they have been accepted uncritically. There is additional risk that the child will react adversely to anesthesia during the operation, but the tubes have additional hazards including changes in the eardrum that may impair its function. Abnormalities were found ranging from 32-67% of cases after tube surgery, with long-range effects not known or studied. There is no agreement as to when tubes should be used. Chiropractic should be a first in all these proposed cases.

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