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Antibiotic Stewardship Programs

What the heck is an Antibiotic/Antimicrobial Stewardship Program (ASP) and what does it have to do with my child’s earache?

Two great questions!  Let us tackle the ASP question first. In general, this term refers to programs put in place by your healthcare provider, in conjunction with guidelines developed by local hospitals or the Centers for Disease Control and Prevention (CDC),  to ensure that antibiotics are prescribed appropriately. Antibiotics play an important role in fighting infection, but when prescribed inappropriately, such as for viral infections or a non-bacteria related middle ear problem, the correct course of treatment is delayed, and the potential for unrelated bacteria to develop resistance to the prescribed antibiotic(s) can become a problem.  

OK, nice to know, but how does this relate to the very real problem of your child’s earache?  The key here is for the healthcare provider to determine if the problem is bacterial in nature or not. Ear pain (otalgia) or redness of the eardrum are some of the signs of Acute Otitis Media (AOM), but as we’ve learned from previous blog posts, other conditions, such as the common cold or pharyngitis can also cause these symptoms. The American Academy of Pediatrics AOM guidelines state that fluid must be present in the middle ear to definitively diagnose AOM. This buildup of fluid and pressure in the middle ear is the direct result of a bacterial infection that would, in most cases, be treated with antibiotics. However, determining if there is fluid in the middle ear is difficult today because the tools currently available are unable to actually image the contents of the middle ear. Given that, the misdiagnosis rate for middle ear related problems is quite high and may result in overuse of antibiotics.

Devices like the OtoSight Middle Ear Scope will allow your healthcare provider to determine the absence or presence of fluid in the middle ear even when there’s occluding ear wax, allowing them to achieve more than a 90% accuracy rate assessing MEE*.

*Otolaryngol Head Neck Surg. 2020 Mar;162(3):367-374

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