Novel Therapy Uses Bacteria to Protect Children From Ear Infections

Jan. 26, 2001 -- A spray therapy that uses a form of "good" bacteria could help protect children from ear infections. Swedish researchers administered the treatment to a group of children who were prone to ear infections and found that many more of them stayed healthy. The controversial study was published in the Jan. 27 issue of the British Medical Journal.

If you have children, it's likely they've had an ear infection. Seven out of every 10 children have at least one bout of the infection of the middle ear, also known as otitis media, by the time they are 3 years old. In some cases, doctors prescribe antibiotics to help healing. But antibiotics have increasingly come under fire because they may promote the spread of more dangerous, antibiotic-resistant bacteria.

This new therapy could offer an alternative treatment to antibiotics, a popular method for handling recurring infections. Although the treatment has not yet received approval in the U.S., the research findings already are stirring debate among pediatricians.

"We use more antibiotics in the U.S. than anywhere else in the world," says Richard J.H. Smith, MD, vice chair of the department of otolaryngology at the University of Iowa in Iowa City. "Part of the reason is that when parents come into the clinic to see a physician, they expect to leave with something." But instead of medication, Smith tells WebMD they should be leaving with reassurance.

"In view of the rising antibiotic resistance in the world, it's important to avoid antibiotic treatment, and this can be a way to do that," lead researcher Kristina Roos, MD, tells WebMD. Roos is an associate professor in the ear, nose, and throat department at Lundby Hospital in Gothenburg, Sweden.

"These [study] results will be very controversial because they offer a very good alternative to antibiotics," Linda Brodsky, MD, chief of pediatric otolaryngology at Children's Hospital of Buffalo, N.Y., tells WebMD. "Furthermore, the 'safety' will not be satisfied until thousands of patients are treated. Placing 'germs' in the throat is difficult to explain to a layperson who won't understand treating infections with other germs, but that is relatively easy to educate and overcome."

The premise of the study is that good bacteria can slow down the growth of the bacteria that commonly cause ear infections, thus protecting against future infections.

To support their theory, Roos and her research team performed a study including more than 100 children aged 6 months to 6 years, all prone to ear infections. Children were given antibiotic treatment for 10 days, and then received either a good bacteria solution or placebo solution sprayed into the nose for an additional 10 days. After two months, they were given the same spray for another 10 days.

At three months, investigators found that nearly half of the children who were given the bacteria spray were healthy, compared with about one-fourth of the children who received the placebo spray.

If approved, the spray could have positive implications for both children and parents, according to Kenneth L. Wible, MD, chief of the section of general pediatrics at Children's Mercy Hospital and Clinic in Kansas City, Mo. "It may mean that some children will be able to avoid unnecessary antibiotic exposure, and we may have a way of dealing with [ear infections] without surgery," he tells WebMD. "It can also mean a lot less suffering, missed days of school, and missed days of work for the parent.

"We prescribe too many antibiotics in this country," Wible says. "But sometimes it's because we have no alternative treatment. One of the nice things about this study is that it offers a treatment that doesn't involve antibiotics."

Reviewed by Michael W. Smith, MD, April 2002