Subscribe to RSS
Should homeopathy be considered as part of a treatment strategy for otitis media with effusion in children?
Received04 December 2012
revised27 January 2013
accepted31 January 2013
17 December 2017 (online)
Background: Otitis media with effusion (OME) or ‘glue ear’ is the most common cause of pediatric hearing loss, and a drain on global healthcare resources. It is associated with frequent episodes of acute otitis media (AOM) and upper respiratory tract infections (URTIs) and linked with environmental and social factors, including diet, smoking households, overcrowding and day care use. Current conventional treatment for OME is unsatisfactory, the area constitutes an ‘effectiveness gap’. Homeopathy is a relatively common and popular choice of complementary and alternative medicine (CAM) treatment for childhood conditions, including otitis media. Antibiotic resistance is now a major global problem, homeopathy may have a role to play in combating its further development.
Method: Systematic review of the literature for clinical studies of homeopathy for AOM and upper respiratory tract disorders. Discussion in the context of current treatment options and public health issues including antibiotic resistance.
Results: Several randomized trials and outcome studies of homeopathy for AOM and upper respiratory tract disorders have been published. The results are encouraging, but the volume of research is small and insufficient to draw definitive conclusions.
Conclusions: A strategy based on multi-centre or multiple, linked clinical trials of homeopathy for OME, using a pragmatic framework and evaluating long-term effects in different settings, in conjunction with other healthcare and social services should be considered. Reduction of antibiotic use is an important outcome.
- 1 Lous J., Burton M.J., Felding J.U., Ovesen T., Rovers M.M., Williamson I. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev 2005 (01): CD001801.
- 2 Vlastarakos P.V., Nikolopoulos T.P., Korres S., Tavoulari E., Tzagaroulakis A., Ferekidis E. Grommets in otitis media with effusion: the most frequent operation in children. But is it associated with significant complications?. Eur J Pediatr 2007; 166: 385-391.
- 3 Viksveen P. Antibiotics and the development of resistant microorganisms. Can homeopathy be an alternative?. Homeopathy 2003; 92 (02) 99-107.
- 4 Simpson S.A., Thomas C.L., van der Linden M.K., Macmillan H., van der Wouden J.C., Butler C. Identification of children in the first four years of life for early treatment for otitis media with effusion. Cochrane Database Syst Rev 2007 (01): CD004163.
- 5 Williamson I., Benge S., Barton S. et al. A double-blind randomised placebocontrolled trial of topical intranasal corticosteroids in 4- to 11-year-old children with persistent bilateral otitis media with effusion in primary care. Health Technol Assess 2009; 13: 1-129.
- 6 Fisher P., van Haselen R., Hardy K., Berkovitz S., McCarney R. Effectiveness gaps: a new concept for evaluating health service and research needs applied to complementary and alternative medicine. J Altern Complement Med 2004; 10 (04) 627-632.
- 7 Clinical Research Evidence in Homeopathy – Present and Future. Available at: http://hpathy.com/scientific-research/clinical-research-evidence-in-homeopathy-present-and-future .
- 8 Doyle W.J., Alper C.M. Prevention of otitis media caused by viral upper respiratory tract infection. Vaccines, antivirals, and other approaches. Curr Allergy Asthma Rep 2003; 3: 326-334.
- 9 Shaikh N., Hoberman A., Kaleida P.H. et al. Otoscopic signs of otitis media. Pediatr Infect Dis J 2011; 30 (10) 822-826.
- 10 Hassmann E., Skotnicka B., Bączek M., Piszcz M. Laser myringotomy in otitis media with effusion: long-term follow-up. Eur Arch Otorhinolaryngol 2003; 261: 316-320.
- 11 Roland P.S., Scoresby T.W. Tympanostomy tubes and otorrhea. Pereira K.D., Mitchell R.B. Pediatric otolaryngology for the clinician. 2009. Totowa, NJ: Humana Press; 61-65.
- 12 Williamson I. Otitis media with effusion. Clin Evid (Online) 2011 Available at: http://www.ncbi.nlm.nih.gov/pubmed/12230672.
- 13 Bluestone C.D., Klein J.O. Otitis media in infants and children. USA: BC Decker; 2007.
- 14 Daly K.A., Hunter L.L., Giebink G.S. Chronic otitis media with effusion. Pediatr Rev 1999; 20 (03) 85-93.
- 15 Wright D., Safranek S. Treatment of otitis media with perforated tympanic membrane. Am Fam Physician 2009; 79 (08) 650-654.
- 16 Otitis Media with Effusion (“glue-ear”). BMJ 2011; 343:d3770. Available at: http://www.bmj.com/content/343/bmj.d3770 .
- 17 Maw A.R. Glue ear in childhood: a prospective study of otitis media with effusion. Cambridge University Press; 1995.
- 18 Butler C.C., MacMillan H. Does early detection of otitis media with effusion prevent delayed language development?. Arch Dis Child 2001; 85 (02) 96-103.
- 19 NHS. National Institute for Health and Excellence: CG60 Surgical management of otitis media with effusion in children. London: RCOG Press; 2008. Available at: http://guidance.nice.org.uk/CG60/Guidance/pdf/English.
- 20 van Cauwenberge P., Watelet J.-B., Dhooge I. Uncommon and unusual complications of otitis media with effusion. Int J Pediatr Otorhinolaryngol 1999; 49 (Suppl. 01) S119-S125.
- 21 Black N., Hutchings A. Reduction in the use of surgery for glue ear: did national guidelines have an impact?. Qual Saf Health Care 2002; 11 (02) 121-124.
- 22 Coyte P.C., Croxford R., Asche C.V., To T., Feldman W., Friedberg J. Physician and population determinants of rates of middle-ear surgery in Ontario. JAMA 2001; 286 (17) 2128-2135.
- 23 Karevold G., Haapkylä J., Pitkäranta A., Kværner K.J. Otitis media surgery: large variability between Finland and Norway. Int J Pediatr Otorhinolaryngol 2007; 71 (07) 1035-1039.
- 24 Browning G.G., Rovers M.M., Williamson I., Lous J., Burton M.J. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev 2010; 10: CD001801 10.1002/14651858.
- 25 Perera R., Haynes J., Glasziou P.P., Heneghan C.J. Autoinflation for hearing loss associated with otitis media with effusion. Cochrane Database Syst Rev 2006; 18 (04) CD006285.
- 26 Emery M., Weber P.C. Hearing loss due to myringotomy and tube placement and the role of preoperative audiograms. Arch Otolaryngol Head Neck Surg 1998; 124 (04) 421-424.
- 27 Alexander N.S., Kulbersh B.D., Heath C.H. et al. MRSA and non-MRSA otorrhea in children: a comparative study of clinical course. Arch Otolaryngol Head Neck Surg 2011; 137 (12) 1223-1227.
- 28 van den Aardweg M.T., Schilder A.G., Herkert E., Boonacker C.W., Rovers M.M. Adenoidectomy for otitis media in children. BMJ 2011; 343: d5154.
- 29 Haapkyla J., Karevold G., Kvaerner K.J., Pitkaranta A. Trends in otitis media surgery: a decrease in adenoidectomy. Int J Pediatr Otorhinolaryngol 2008; 72: 1207-1213.
- 30 Paradise J.L., Feldman H.M., Campbell T.F. et al. Tympanostomy tubes and developmental outcomes at 9 to 11 years of age. N Engl J Med 2007; 356 (03) 248-261.
- 31 Williams C.J., Jacobs A.M. The impact of otitis media on cognitive and educational outcomes. Med J Aust 2009; 191 (09) 69-72.
- 32 Kong K., Coates H.L.C. Natural history, definitions, risk factors and Burden of otitis media. Med J Aust 2009; 191 (09) 39-43.
- 33 Morris P.S., Leach A.J., Silberberg P. et al. Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey. BMC Pediatr 2005; 5: 27.
- 34 Watson K., Carville K., Bowman J. et al. Upper respiratory tract bacterial carriage in Aboriginal and non-Aboriginal children in a semi-arid area of Western Australia. Pediatr Infect Dis J 2006; 25 (09) 782-790.
- 35 Bowd A.D. Otitis media: health and social consequences for aboriginal youth in Canada's north. Int J Circumpolar Health 2005; 64 (01) 5-15.
- 36 Homøe P. Otitis media in Greenland. Studies on historical, epidemiological, microbiological, and immunological aspects. Int J Circumpolar Health 2001; 60 (02) 1-54.
- 37 Paradise J.L., Rockette H.E., Colborn D.K. et al. Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the first two years of life. Pediatrics 1997; 99 (03) 318-333.
- 38 McCormick D.P., Chonmaitree T., Pittman C. et al. Nonsevere acute otitis media: a clinical trial comparing outcomes of watchful waiting versus immediate antibiotic treatment. Pediatrics 2005; 115 (06) 1455-1465.
- 39 Corbeel L. What is new in otitis media?. Eur J Pediatr 2007; 166: 511-519.
- 40 Klein J.O. The burden of otitis media. Vaccine 2000; 19 (Suppl. 01) S2-S8.
- 41 Uhari M., Mäntysaari K., Niemelä M. Meta-analytic review of the risk factors for acute otitis media. Clin Infect Dis 1996; 22 (06) 1079-1083.
- 42 Sanders S., Glasziou P.P., Del Mar C.B., Rovers M.M. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev 2004
- 43 Dagan R., Leibovitz E., Cheletz G., Leiberman A., Porat N. Antibiotic treatment in acute Otitis Media promotes superinfection with resistant Streptococcus pneumoniae carried before initiation of treatment. J Infect Dis 2001; 183 (06) 880-886.
- 44 Boonacker C.W., Broos P.H., Sanders E.A., Schilder A.G., Rovers M.M. Cost effectiveness of pneumococcal conjugate vaccination against acute otitis media in children: a review. Pharmacoeconomics 2011; 29 (03) 199-211.
- 45 O'Brien M.A., Prosser L.A., Paradise J.L. et al. New vaccines against otitis media: projected benefits and cost-effectiveness. Pediatrics 2009; 123 (06) 1452-1463 xx.
- 46 Spiro D.M., Arnold D.H. The concept and practice of a wait-and-see approach to acute otitis media. Curr Opin Pediatr 2008; 20 (01) 72-78.
- 47 Friese K.H., Kruse S., Lüdtke R., Moeller H. The homoeopathic treatment of otitis media in children–comparisons with conventional therapy. Int J Clin Pharmacol Ther 1997; 35 (07) 296-301.
- 48 Rise M.B., Steinsbekk A. How do parents of child patients compare consultations with homeopaths and physicians? A qualitative study. Patient Educ Couns 2009; 74 (01) 91-96.
- 49 Ullman D., Frass M. A review of homeopathic research in the treatment of respiratory allergies. Altern Med Rev 2010; 15 (01) 48-58.
- 50 Mathie R.T. Systematic reviews of RCTs in homeopathy a focused appraisal. Focus Altern Complement Ther 2010; 15 (02) 104-106.
- 51 Fisher P., Berman B., Davidson J., Reilly D., Thompson T. Are the clinical effects of homoeopathy placebo effects?. Lancet 2005; 366 (9503): 2082-2083.
- 52 Linde K., Clausius N., Ramirez G. et al. Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997; 350 (9081): 834-843.
- 53 Reilly D., McSharry C., Taylor M., Aitchison T. Is homeopathy a placebo response? Controlled trial of homeopathic potency, with pollen in hayfever as model. Lancet 1986; 328 (8512): 881-886.
- 54 Sevar R. Audit of outcome in 455 consecutive patients treated with homeopathic medicines. Homeopathy 2005; 94 (04) 215-221.
- 55 Thompson E.A., Mathie R.T., Baitson E.S. et al. Towards standard setting for patient-reported outcomes in the NHS homeopathic hospitals. Homeopathy 2008; 97 (03) 114-121.
- 56 Jacobs J., Springer D.A., Crothers D. Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. Pediatr Infect Dis J 2001; 20 (02) 177-183.
- 57 Sinha M.N., Siddiqui V.A., Nayak C. et al. Randomized controlled pilot study to compare Homeopathy and Conventional therapy in Acute Otitis Media. Homeopathy 2012; 101 (01) 5-12.
- 58 Frei H., Thurneysen A. Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution?. Br Homeopath J 2001; 90 (04) 180-182.
- 59 Harrison H., Fixsen A., Vickers A. A randomized comparison of homoeopathic and standard care for the treatment of glue ear in children. Complement Ther Med 1999; 7 (03) 132-135.
- 60 Altunç U., Pittler M.H., Ernst E. Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials. Mayo Clin Proc 2007; 82 (01) 69-75 xx.
- 61 Shang A, Huwiler-Müntener K, Nartey L, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet 366(9487): 726–732.
- 62 Rutten A.L.B., Stolper C.F. The 2005 meta-analysis of homeopathy: the importance of post-publication data. Homeopathy 2008; 97 (04) 169-177.
- 63 Faculty: research http://www.facultyofhomeopathy.org/research/ .
- 64 Thompson E.A., Bishop J.L., Northstone K. The use of homeopathic products in childhood: data generated over 8.5 years from the Avon Longitudinal Study of Parents and Children (ALSPAC). J Altern Complement Med 2010; 16 (01) 69-79.
- 65 Simpson N., Roman K. Complementary medicine use in children: extent and reasons. A population-based study. Br J Gen Pract 2001; 51 (472) 914-916.
- 66 Du Y., Knopf H. Paediatric homoeopathy in Germany: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Pharmacoepidemiol Drug Saf 2009; 18 (05) 370-379.
- 67 Steinsbekk A., Lüdtke R. Patients' assessments of the effectiveness of homeopathic care in Norway: a prospective observational multicentre outcome study. Homeopathy 2005; 94 (01) 10-16.
- 68 Marian F., Joost K., Saini K.D., von Ammon K., Thurneysen A., Busato A. Patient satisfaction and side effects in primary care: an observational study comparing homeopathy and conventional medicine. BMC Complement Altern Med 2008; 8 (01) 52.
- 69 Rossi E., Bartoli P., Panozzo M., Bianchi A., Da Frè M. Outcome of homeopathic treatment in paediatric patients: an observational study from 1998 to 2008. Eur J Integr Med 2010; 2 (03) 115-122.
- 70 Steinsbekk A., Bentzen N., Brien S. Why do parents take their children to homeopaths? – an exploratory qualitative study. Forschende Komplementarmedizin 2006; 13 (02) 88-93.
- 71 Ekins-Daukes S., Helms P.J., Taylor M.W., Simpson C.R., McLay J.S. Paediatric homoeopathy in general practice: where, when and why?. Br J Clin Pharmacol 2005; 59 (06) 743-749.
- 72 Robinson T.W. Responses to homeopathic treatment in National Health Service general practice. Homeopathy 2006; 95 (01) 9-14.
- 73 Spence D.S., Thompson E.A., Barron S.J. Homeopathic treatment for chronic disease: a 6-year, university-hospital outpatient observational study. J Altern Complement Med 2005; 11 (05) 793-798.
- 74 Mathie R.T., Fisher P. Homeopathy is safe and does not lack positive evidence in clinical trials. Br J Clin Pharmacol 2007; 64 (03) 396-397.
- 75 Jain A. Does homeopathy reduce the cost of conventional drug prescribing? A study of comparative prescribing costs in General Practice. Homeopathy 2003; 92 (02) 71-76.
- 76 Rossi E., Crudeli L., Endrizzi C., Garibaldi D. Cost–benefit evaluation of homeopathic versus conventional therapy in respiratory diseases. Homeopathy 2009; 98 (01) 2-10.
- 77 Van Wassenhoven M. An observational study of patients receiving homeopathic treatment. Homeopathy 2004; 93 (01) 3-11.
- 78 Rutten L. et al. Evidence and plausibility: the case of homeopathy. Med Health Care Philos 2012 10.1007/s11019-012-9413-9.
- 79 Jacobs J., Fisher P. Polypharmacy, multimorbidity and the value of integrative medicine in public health. Eur J Integrat Med 2012 http://dx.doi.org/10.1016/j.eujim.2012.09.001.
- 80 Rossignol M., Begaud B., Engel P. et al. Impact of physician preferences for homeopathic or conventional medicines on patients with musculoskeletal disorders: results from the EPI3-MSD cohort. Pharmacopepidemiol Drug Saf 2012; 21 (10) 1093-1101.
- 81 Oberbaum M., Singer S.R., Vithoulkas G. The colour of the homeopathic improvement: the multidimensional nature of the response to homeopathic therapy. Homeopathy 2005; 94 (03) 196-199.
- 82 Hugh M. Pragmatic clinical trials. Complement Ther Med 2004; 12 (2–3): 136-140.
- 83 Thorpe K.E., Oxman A.D., Treweek S., Furberg C.D. Pragmatic trials are randomized and may use a placebo. J Clin Epidemiol 2010; 63 (06) 694-695.
- 84 Fixsen A. Reflections on a research project into glue ear. Homeopathy 2000 (78).