A homeopathic approach to acute otitis media

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By Amalia Punzo, MD, CHCQM-PHYADV

Acute infections of the inner ear, known as acute otitis media (AOM), present a common and ongoing challenge to practitioners. AOM is a leading cause of pediatric healthcare visits and the most frequent reason children are administered antibiotics or undergo surgery. According to the journal, American Family Physician, by three years of age, 50 to 85 percent of children will have at least one episode of AOM.

Homeopathy has a long history of successful treatment of AOM. A study in Global Advances in Health and Medicine concluded, “Homeopathy appears equivalent to and safer than conventional standard care in comparative effectiveness trials.” This article will focus on a painful condition commonly seen in day-to-day practice and within our own families.

AOM happens when fluid is trapped behind the tympanic member or eardrum and becomes infected. AOM often occurs after a viral respiratory illness. The eustachian tube may become blocked with thick fluid or mucus as a result of the viral infection and subsequently trapped within the eustachian tube behind the tympanic membrane (the ear drum). Ear pain is the symptom, often sudden and quite severe. Babies may rub, tug, or hold the ear in obvious pain. Fever, irritability, lethargy, excessive crying, reduced appetite, and vomiting may also be present. Diagnosis is by otoscopic examination revealing a red and bulging tympanic membrane. Pus may or may not be visualized. Advanced or more severe cases of AOM may cause perforation of the tympanic membrane.

Current evidence supports use of antibiotics for AOM in only specific clinical situations. There are mounting concerns regarding antibiotic resistance and inappropriate administration of antibiotics. A 2021 World Health Organization (WHO) report stated that antibiotic resistance is rising to dangerously high levels all over the globe. This WHO report estimated that by 2050, 10 million deaths worldwide may result from antibiotic resistance, making it deadlier than cancer. The report calls for “urgent action to avert antimicrobial resistance crisis.”

Antibiotic stewardship, then, is strongly encouraged given studies showing that board-spectrum antibiotic prescribing in ambulatory pediatrics is common and frequently inappropriate. A period of observation and over-the-counter (OTC) pain management with acetaminophen and/or ibuprofen is recommended for acute uncomplicated AOM. Many parents are often hesitant about administering analgesics. As holistically minded integrative health practitioners, we often consult with parents regarding alterative options to over-the-counter pain medications for effectively treating AOM.

A randomized double-blind placebo control pilot study published in Pediatric Infectious Disease showed a statistically significant decrease in symptoms with individualized homeopathic treatment of AOM. There were also fewer treatment failures in the group receiving homeopathy. Prompt and appropriate administration of homeopathy provides a welcome solution to both treating the acute infection and providing rapid pain relief.

Homeopathic medicines can be found over the counter, online, or ordered directly from homeopathic pharmacies that must adhere to strict United States Food and Drug Administration (FDA) regulations for production in accordance with manufacturing standards as outlined by the Homeopathic Pharmacopoeia of the United States (HPUS). The starting dose for self-treatment of AOM is typically 12, 15 or 30 centesimal dilution. They may be given as dry pellets directly into the mouth or in water (four to six ounces), stirred, and given as a teaspoon every 30 to 60 minutes until symptom relief occurs. Once symptom relief is observed (which can remarkably begin in just minutes), further repetitions are given only as needed. If symptoms are not improving after a few hours, it is often necessary to reevaluate the homeopathic medicine administered and determine if a different medicine is indicated. With study and practice, this becomes easier to determine.

Here are just a few of the more commonly indicated homeopathic medicines for AOM. Serious or recurrent infections should be seen and treated by an experienced homeopathic professional. If no relief is seen within 24 hours of homeopathic treatment, consult an experienced homeopathic professional.

The keys to selecting the single most effective homeopathic medicine or remedy are in the details of the most characteristic traits or modalities as discussed below. The goal is always to match as many of these characteristic symptoms as possible to the single homeopathic medicine that best fits or describes this “totality of characteristic symptoms.” Rapid homeopathic treatment with the most appropriate medicine will lead to a remarkably fast recovery.

Belladonna: Children or toddlers requiring this medicine have intense earaches that are sudden in onset and associated with high fevers and characterized by redness of the ear, inside the ear, and redness of the ear itself. The ear drum is bulging and often very erythematous on examination. Laterality is often important for a homeopathic prescription, and Belladonna is often right sided.

Chamomilla: The child requiring homeopathic Chamomilla is often very fussy, cannot be pleased or consoled. He or she will throw aside or push away items just demanded. They can be held or rocked for a short period of time, but this only gives them temporary relief. This extreme sensitivity, irritability, and acute temperament is quite characteristic when the homeopathic medicine, Chamomilla, is indicated. Very often the need for Chamomilla may be associated with painful teething. Once appropriately administered, the child will experience almost immediate relief.

Aconitum: This homeopathic medicine is useful for any number of rapid onset acute conditions characterized by infections that begin after exposure to cold, usually dry, air or wind. There is often a fever, severe anxiety even to the point of panic, and restlessness. There may be a dry cough accompanying the ear pain and fever and typically an increase in thirst. This medicine, if indicated, should be given within the first few hours up to 24 hours after the development of symptoms when the etiology is a suddenness of symptoms after exposure to cold. After that time, the child usually will usually progress to one of the other commonly indicated homeopathic medicines listed here.

Pulsatilla: Indications for this homeopathic medicine are very characteristic in that the child wants to be cuddled, consoled, rocked, and held. They crave affection and are whiny rather than irritable. There is often little to no thirst. Thick nasal discharges may be present particularly if the child also has had recently cold symptoms. These discharges if present are thick and yellow or even greenish. Warmth and heat aggravate the symptoms of a child needing Pulsatilla. The other symptom of note for pulsatilla in general is changeability. The child’s moods and symptoms often change in a matter of minutes.

Hepar sulphuris (Hepar sulphuris calcareum or hepar sulph for short): The child or person needing Hepar sulph is cold and worse from any draft. They are very sensitive to touch and are irritable. They want to be covered because they are so cold. The coldness and “worse from cold” is a key note or leading symptom for selecting this medicine.

Mercurius: The earache often occurs after exposure to damp or changing weather. There is a great deal of salivation and bad breath, and the patient is quite sweaty and often smells foul or ill. The symptoms are worse at night. The tongue is large and flabby and often shows an imprint of the teeth on the edges.

There is a great deal of interest and practice of self-care using homeopathy for mild acute complaints. If you are a practitioner interested in becoming proficient in homeopathic prescribing for your patients and clients, I recommend taking a course in acute prescribing and/or working with an experienced homeopath to become proficient and comfortable with selecting and administering homeopathic medicines.

Editor’s note: For a brief introduction to homeopathy, including its historical background, research base, and core principles, please read Molly Punzo’s first article for Integrative Practitioner here.

References:

Balkhy,H.(2021) Update on AMR. Developing a fit for purpose response. World Health Organization. Retrieved from: https://www.hhs.gov/sites/default/files/who-update-amr.pdf

Bell, I.  (2013) Homeopathic medications as clinical alternatives for symptomatic care of acute otitis media and upper respiratory infections in children.  Global Advances in Health and Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833578/

Gaddey, H.  (2019) Otitis media: Rapid evidence review.  American Family Physician. Retrieved from: https://www.aafp.org/pubs/afp/issues/2019/0915/p350.html

Hersh, A.  (2011) Antibiotic prescribing in ambulatory pediatrics in the United States. Pediatrics. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/22065263/

Jacobs, J.  (2001) Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial.  The Pediatric Infectious Disease Journal. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/11224838/

Marom, T.  (2014) Trends in otitis media-related health care use in the United States, 2001-2011.  JAMA Pediatrics. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/24276262/

Milligan, S. (2013) Should children with acute otitis media routinely be treated with antibiotics? No: Most children older than two years do not require antibiotics.  American Family Physician. Retrieved from: https://www.aafp.org/pubs/afp/issues/2013/1001/od2.html

Van, R. (2019) Pain management in acute otitis media: a qualitative study of parents’ views and expectations.  BMC Family Practice. Retrieved from: https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-019-0908-9

Amalia (Molly) Punzo, MD, CHCQM-PHYADV is a graduate of the University of Connecticut School of Medicine. She completed her residency and fellowship in Internal Medicine at Hartford Hospital in 1992. While in Connecticut, she began Hartford Hospital’s Inpatient Department of Integrative Medicine and outpatient Center for Integrative Medicine and Pain Management in Hartford, Conn. in 2000. Her interest in integrative health and homeopathy began shortly after starting private practice. She is a published author and has advocated and lectured on behalf of homeopathy and integrative medicine for decades. She served on the board of the National Center for Homeopathy from 2000 to 2010 and is a current board member of the American Institute for Homeopathy (AIH). She is an acting liaison between the AIH and the Academy of Homeopathy Education (AHE) to promote quality homeopathic education to licensed healthcare professionals. She and her husband currently reside between Florida and Maine.