Antibiotic resistance, Otitis Media and Homeopathy. What does the evidence say?

First published by Aurum Project Blog 20 Nov 2022  ​https://aurumproject.org.au/antibiotic-resistance-otitis-media-homeopathy/ 

​Complementary medicine can be used in the treatment of otitis media (aka ear infection). The use of properly prescribed homeopathic medicine (by a registered homeopath) can lead to:

• faster relief
• decreased pain
• and quicker resolution of infection, in combination with conventional therapy. (1)

 
Advantages for homeopathy in otitis media are:

• lower antibiotic fill rates
• less serious side effects
• no drug interactions
• reduced parental leave from work! (2)

 
Systematic reviews have found:

• Mild treatment effect for homeopathic medicine in otitis media. (3)
• Reduction of antibiotic use. (4)
• Clinical efficacy and effectiveness of homeopathy in acute paediatric infections are favourable in terms of faster responses, fewer and less serious side effects, and cost savings. (5,6) 

 
Two well regarded randomized controlled trials (RCT) showed promising results for homeopathic medicine in the treatment of otitis media with:

• Significant decrease in symptoms of otitis media at 24 and 64 hours after homeopathic treatment. (7)
• Early homeopathic treatment resulted in nil antibiotics in the homeopathy group. (8)

  

An observational study found pain control in 40% of children after 6hours, with resolution of all otitis media symptoms being twice as fast with homeopathic medicine (9)
 
An Aurum Project retrospective case series analysis (10) found significant potential for homeopathic treatment of otitis media and otitis media with effusion (aka glue ear).

​A guide to common homeopathic medicines for otitis media can be found as part of Marom et al., 2016 (3) systematic review (copyright prohibits sharing here).  
 
 
Avoiding cow’s milk? Systematic review (11) found a cow's milk protein allergy in 11% of children who underwent ENT procedures, in 40% of children with otitis media with effusion, and a higher overall tendency to otitis media.

Since the 1990’s expert opinion has swung against doctors giving antibiotics for otitis media (12) however, in Australia, the highest rate of dispensing antibiotics in under 65’s is for children aged between two and four most commonly for – you guessed it… otitis media (13).

The Royal Australian College of General Practitioners recommend that otitis media in non-indigenous children between the ages of two to twelve years should not be treated with antibiotics unless there are signs of widespread infection. (14)
 
Four years’ ago antibiotic resistance began to apply to our ‘reserve’ antibiotics (15) but scarily antibiotics are still being overprescribed (in direct contravention of national evidence-based prescribing guidelines) with ever increasing rates of resistant bacteria in our communities. (16)
 
A 2018 study showed British GP’s using complementary medicine - including homeopathy - prescribed 22% fewer antibiotics. (17) 

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References

1. Nathan et al., 2022. Complementary/Integrative Medicine for Pediatric Otitis Media. Otolaryngol Clin North Am. Oct;55(5):1055-1075. Available from: https://pubmed.ncbi.nlm.nih.gov/36088163/
2. Bell and Boyer. 2013. Homeopathic medications as clinical alternatives for symptomatic care of acute otitis media and upper respiratory infections in children. Glob Adv Health Med. Jan;2(1):32-43. Available from: https://pubmed.ncbi.nlm.nih.gov/24381823/
3. Marom et al., 2016. Complementary and Alternative Medicine Treatment Options for Otitis Media: A Systematic Review. Medicine (Baltimore). Feb;95(6):e2695. Available from: https://pubmed.ncbi.nlm.nih.gov/26871802/
4. Fixsen. 2013. Should homeopathy be considered as part of a treatment strategy for otitis media with effusion in children? Homeopathy. Apr;102(2):145-50. Available from: https://pubmed.ncbi.nlm.nih.gov/23622265/
5. Bellavite et al., 2011. Advances in homeopathy and immunology: a review of clinical research. Front Biosci (Schol Ed). Jun 1;3(4):1363-89. Available from: https://pubmed.ncbi.nlm.nih.gov/21622275/
6. Bukutu et al., 2008. Complementary, holistic, and integrative medicine: therapies for acute otitis media. Pediatr Rev. Jun;29(6):193-9. Available from: https://pubmed.ncbi.nlm.nih.gov/18515336/
7. Jacobs J, Springer DA, Crothers D. 2001. Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. Pediatric Infectious Diseases Journal [online]. Feb;20(2):177-83. Available from https://pubmed.ncbi.nlm.nih.gov/11224838/
8. Sinha et al., 2012. Randomized controlled pilot study to compare Homeopathy and Conventional therapy in Acute Otitis Media. Homeopathy. 2012 Jan;101(1):5-12. Available from; https://pubmed.ncbi.nlm.nih.gov/22226309/
9. Frei & Thurneysen. 2001. Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution? Br Homeopath J. Oct;90(4):180-2. Available from: https://pubmed.ncbi.nlm.nih.gov/11680801/
10.  Baron & Jordan, 2014. Analysis of a Modern Approach to the Homoeopathic Treatment of Chronic and Acute Ear Problems in Children. Journal of The Australian Traditional Medicine Society. 20; 3. Meadowbank, New South Wales. The Australian Traditional Medicine Society.
11.  Oliveira et al., 2022. Correlation between cow's milk protein allergy and otitis media: a systematic review. Braz J Otorhinolaryngol. 2022 Sep-Oct;88(5):803-811. Available from: https://pubmed.ncbi.nlm.nih.gov/34716104/
12.  https://www.abc.net.au/health/thepulse/stories/2011/04/06/3183024.htm
13. https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aura-2019-third-australian-report-antimicrobial-use-and-resistance-human-health
14.  https://www.healthdirect.gov.au/ear-infection
15.  https://www.nps.org.au/news/antibiotic-resistance-in-australia-here-and-now
16. https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-surveillance-system/aura-2021
17. van der Werf et al., 2018. Do NHS GP surgeries employing GPs additionally trained in integrative or complementary medicine have lower antibiotic prescribing rates? Retrospective cross-sectional analysis of national primary care prescribing data in England in 2016. BMJ Open. Mar 5;8(3):e020488. Available from: https://pubmed.ncbi.nlm.nih.gov/29555793/