By Sharon Salyer
Herald Writer
If your child has an ear infection or you have a sore throat, expect some new rules during this cold and flu season on what kind of medicine you’ll get from your doctor.
Patients probably won’t get antibiotics for these and a wide range of other viral ailments, as they commonly have in the past, a coalition of local and statewide medical groups said Tuesday.
The reason: A near-epidemic increase in antibiotic resistance where bacterial bugs essentially become immune to antibiotics.
"The key message to the public is to choose the right drug for the right bug," said Dr. Jeff Robertson, medical director for Regence BlueShield. Nasty illnesses — including earaches, sinus infections, bronchitis, sore throats, colds and flu — are often caused by viruses.
Antibiotics, designed to kill bacterial germs, have no effect on viruses. Patients need to understand this difference, he said. "Distinguish a bug from bacteria."
Scientists have known since the 1940s that the more an antibiotic is used, the less effective it becomes, said Dr. Art Sprenkle, who heads a statewide group on antibiotic education. It includes the Washington State Medical Association, Group Health, University of Washington medical school, The Everett Clinic and two of the state’s biggest health insurance plans, Premera Blue Cross and Regence BlueShield.
The problems of increasing antibiotic resistance are seen both here and across the nation, said Dr. Maxine Hayes, who heads the state Health Department.
Two patients die every hour in the U.S. because of complications from antibiotic resistance, she said.
In Washington, doctors have noticed that vancomycin, a common antibiotic, is increasingly ineffective in killing off a bacterial bug that causes pneumonia and other common infections.
"We’re asking physicians to resist the temptation to cave in" and write antibiotic prescriptions for flu-like illnesses and sore throats, she said. "It will contribute to growing antibiotic resistance."
A previous study by Premera and the UW School of Medicine shows that ear infections are the number one reason why antibiotics are prescribed in medical clinics, said Dr. Peter West, Premera’s medical director, even though antibiotics do no good against this type of infection.
Antibiotic use in children has increased nearly 50 percent in children since 1980, according to a study by the Centers for Disease Control and Prevention.
Pleas for patients to cut back on requests for antibiotics could be a tough sell, West acknowledged, because viral ear infection symptoms seem to disappear after children are given antibiotics. Instead, the body’s immune system has fought off the bug.
At The Everett Clinic, complications from colds are one of the most common reasons patients ask for antibiotics, said Dr. Yan-Po Tu.
"People come in for a stuffy nose and have been sick three to four days," he said. "They say, ‘Doc, give me a pill to make me better in 24 hours or less.’"
Only two out of ten sore throats can properly be treated with antibiotics, he said.
So what should a parent do when faced with a preschooler who has an ear infection or has a feverish cold?
Half of all ear infections will heal without medications, he said. His advice to parents: Treat the symptoms, using nonaspirin pain relievers such as Tylenol for ear pain. "Kids will settle down in an hour or two with an appropriate dose," he said.
For older children, apply warm compresses to warm the ear and reduce pain. For small children, put a few drops of gently warmed olive oil in the ear to give some relief.
Use saline drops or hold a child for a few minutes around a steamy shower to reduce congestion in the nose, which triggers ear pressure and pain, he added.
You can call Herald Writer Sharon Salyer at 425-339-3486
or send e-mail to salyer@heraldnet.com.
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