Botanical Consensus Statement for the Management of Pediatric Therapeutics: Otitis Media

This article discusses the pathophysiology, biomedical and holistic risk factors, diagnosis, and botanical management of pediatric therapeutics for otitis media. It includes a botanical consensus statement for the management of pediatric therapeutics for otitis media.

Running head: advanced herbal medicine 1
Botanical consensus statement for the management of pediatric therapeutics: otitis media
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Pathophysiology of Pediatric Therapeutics: Otitis Media
Otitis media (OM) is one of the single most predominant illnesses in childhood, just after upper
respiratory diseases. It also contributes significantly to the reason why many people make
frequent appointments with a practitioner. For about a year, an approximated 16 million hospital
attendants are as a result of OM infections. Otitis media are all inflammations at the center of the
ear, regardless of etiology or pathogenesis (Wetmore, Muntz, & McGill, 2012).
One of the delicate parts of the ear attacked by most infections is the Eustachian Tube
Dysfunction (ETD) whereby the mucosa at the pharyngeal of ET which is part of the mucociliary
at the center of the ear. Mucosa by tumor, edema, or the opposite intratympanic force causes a
proportional stretch which could cause an infection in the nasopharynx down to the central part
of the ear leading to otitis media. Esophageal components disgorged into the center of the ear
and at the nasopharynx via the Eustachian Tube which may cause distractions at the central ear
which may also facilitate inflammation. Researches from various fields show how Upper
Respiratory Infection (URI) leads to ETD, its contribution to high bacterial infection
establishment and its close attachment to the nasopharynx (Møller, 2010).
International statistics show that in the developing world, otitis media is very predominant and it
is one of the main reasons as to why infants' mortality rates are high. This is as a result of its
complicated signs and symptoms that take longer to be noticed when too much harm is already
done (Focus Medica Pte Ltd, 2008).

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Considering demographics associated with age, sex and race, a high dominance of Otitis media
in both genders is common in small babies of six months to one year those that are diagnosed
with Acute Otitis Media with a period of one year since birth is likely to experience an otitis
media recurrent. There is much evidence of acute otitis media dominance in males than in
females, a recent statistic data from the US recorded more OM cases in boys than in girls. A
study on the effects of socioeconomic and other related factors between blacks and whites were
unvarying. Hispanic children and Indian children have greater dominance of acute otitis media
then the black and white Americans (Mathur, 2012).
Biomedical Risk Factors of Pediatric Therapeutics: Otitis Media
Chronic otitis media commonly referred to as COM and ROM also referred to as Recurrent
Otitis Media negatively influence various cultures and subspecies have settled in both less
developed and developed nations. A cross-sectional research done on 9 nations across 3
continents demonstrated that a dominant illness is relevant enough to be regarded for a serious
medical attention. These two illnesses could cause a hearing and vocal disability. Chronic Otitis
Media could lead to intracranial or even extracranial health challenges. Proper cure of these
illnesses depends on proper comprehension of these risks (Adunka & Buchman, 2011).
Some of the risk factors that are related to both COM and ROM are as follows: tribe and
ethnicity, biological factors, sex, personal hygiene, allergy infections and infant-feeding
methods. Even though various presented cases were challenging to analyze due to an
insufficiency of proper definitions, expected diagnostic procedure and monitoring sets to develop
and manage the capable study standards (Preciado, 2015).

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Holistic Risk Factors of Pediatric Therapeutics: Otitis Media
Immune system
The immune systems of the newly born children and the weak immune systems of adults with
immune deficiencies since birth, HIV, and diabetic patients have high chances of developing
otitis media. Otitis media thrives faster in bodies with a weak immune system. The interaction
connecting pathogens and the body immune system takes part in fighting back the illness
sequence (Smith, 2014).
Genetic predisposition
In spite of genetic subset of Otitis media that have been shown by various fields of study that
evaluated familial relationships of Otitis Media distinguishing both genetic and environmental
factors is a great challenge. There are no particular families that are associated with otitis media
that are vulnerable. Even though environmental factors contribute greatly to most genetic
explicates including Otitis Media pathogens (Handa, 2013).
Mucins
Functions of mucins in Otitis media with effusion are known to be accountable for the gel-like
attribute of mucus discharge. The middle ear mucus gene is different from the nasopharynx. The
differences between the two genes have contributed prevalently in the development of OME and
lack of control of MUC5B in the middle ear.
Physiologic dysfunction

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A variation in the physiologic roles of the E-tube mucosa, which includes ciliary dysfunction or
edema, raises the danger of bacterial establishment of the central ear which may lead to otitis
media infection. The backward flow checkups should be conducted in relation to COM
diagnosis. In case the reflux is diagnosed it should be treated together with the basic illness or
infection (Wetmore & Rubin, 2015).
Other host factors
Lack of Vitamin A in the immune system is a root cause of acute otitis media and upper
respiratory infections.
Obesity is also associated with the ascending cases of OM, even though the basic influencing
factor is not yet established. Conclusions have it that disturbance of innate cytokine nature
causes gastroesophageal backflow and changes monthly flora and fat proliferation monthly. All
of these have been associated with the rising cases of Otitis Media infection. Alternatively, OM
may cause obesity by tampering with the taste buds.
Bacterial pathogens
Some of the widespread bacterial pathogens in acute otitis media are Streptococcus pneumoniae,
nontypeable Haemophilus influenzae, and Moraxella (Branhamella) catarrhalis. All these
pathogens are accountable almost all acute otitis media incidences in relation to the origin of
bacterial infections. A suggestion that the MEE that is related to OME was unproductive since
components of the central ear liquids are extracted by tympanocentesis hence it rarely hosted
bacteria. M catarrhalis– instigate the Acute Otitis Media is different from AOM that is as a
result of other bacterial pathogens in other ways.

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Viral pathogens
Since acute viral Upper respiratory infection is a strong contributor to AOM growth, various
researches have proved its roles investigators in AOM pathogenesis. They have also
demonstrated that viruses can transform the body-immune defense to Acute Otitis Media. This
causes a dominant central ear liquid discharge and an establishment of CMO chronic otitis media
effusion. Several viruses that are closely related to AOM are RSV or rather respiratory syncytial
virus, adenovirus, influenza viruses, rhinovirus, parainfluenza viruses, and. (HPeV1) also known
as Human parechovirus 1 illness which is related to Otitis Media and coughs in pediatric clients
(Kohan & Chandrasekhar, 2014)
Factors related to allergies
The relationship between allergies and Otitis Media infections is not yet very clear. As the
immune system of children under the age of four years continues to grow, allergies are not likely
to take part in the recurrent Acute Otitis Media at this age. Even though some studies indicate
that allergies lead to the pathogenesis of Otitis Media in teenagers and adults, deeper
observations deny the contribution of allergies as an origin of central ear illnesses (Siva &
Lampl, 2014).
Infant feeding methods
Various studies demonstrate that infant feeding in the first six months is very essential in
safeguarding them from otitis media as it lasts for the next up to twelve months after
breastfeeding is over. Positive effects of breastfeeding impede the attacks of the initial Otitis
Media phases and recurrence of Otitis Media.

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Passive smoke exposure
Various studies have proven a close association between passive smoking condition and dangers
of central ear illnesses.
Group daycare attendance
Close contacts amongst children in daycare centers increase the chances of respiratory illnesses
amongst them together with other infections such as otitis media nasopharyngeal and pathogenic
microbes. This is because they are exposed to antibacterial-resistant infections in their
nasopharynx, which is a major contributor to acute otitis media which might be fractious to over
the counter treatment and antibiotics. Several guidelines have been suggested such as frequent
amoxicillin-clavulanate as an effective antibiotic in the medication of Acute Otitis Media
(Ratnesar, 2012).
Diagnosis of Pediatric Therapeutics: Otitis Media
 Acute otitis media (AOM) diagnoses can be conducted in people who are suspected or
observed with brutal secretions from the Tympanic Membrane TM, or alien assault of
otorrhea. This not because of acute otitis media externa or gentle bulging of the tympanic
membrane or dated assault of pain in the ear and strained erythema of the TM (Brackmann &
Arriaga, 2009).
 Bilateral Acute Otitis Media in children of less than 2 years should be administered for the
Antibiotic therapy especially those with brutal AOM symptoms.

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 Antibiotic therapy can also be administered or waiting for observation given with regular
checkups, for mild acute otitis media unilateral in children of more than 2 years of age and
above (Youngblood, 2014).
 Amoxicillin antibiotics should be given or recommended to Acute Otitis Media patients when
a prior agreement is attained to try out antibiotics except in cases where a child or the patient
has been using amoxicillin for the last thirty days, or the patient has simultaneous suppuration
conjunctivitis, if he or she is allergic to penicillin, or the patient has encountered a recurrent
acute otitis media that resisted amoxicillin.
 To decrease the AOM episodes reoccurrence in patients Prophylactic antibiotics should not be
administered to them (Bas, 2017).
Conventional Medical Management of Pediatric Therapeutics: Otitis Media
 In basic diagnostic techniques for OME, a Pneumatic otoscopy is recommended in patients or
children with otalgia, suspected hearing loss, or both. Tympanometry can be acquired in the
cases where diagnose is not certain.
 Guardians who miss the infants hearing tests session should be made aware of the need of
regular checkups to make sure that the sense is clear and right after OME is treated to avoid
possible sensorineural hearing cut off.
 A child diagnosed with otitis media with effusion and is at a risk of vocalization disability or
oral communication challenges because of basic mental, sentimental or behavioral influences
should be frequently examined for communication and a necessity for immediate intervention.

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 For children with Otitis Media with effusion and does not have high chances of being in great
danger should be monitored for three months after effusion is assaulted if aware or after a
diagnostic process.
 Hearing screens should be done when Otitis Media with effusion last for three or more months
or any other time that communication is prolonged and when there is an impact in hearing cut
off is noticed in people with OME. Patients suffering from chronic otitis media with effusion
should be monitored for more than six months until the effusions seize completely where
structural changes and eardrum damages are identified and examined as recommend (Gibbin
& Bradley, 2012).
Botanical Management of Pediatric Therapeutics: Otitis Media
Desired objectives
American Academy of Pediatrics acute otitis media principals requires adults and specialists to
consider the benefits of minimal usage of antibiotic in AOM treatment. Antagonistic drug
incidents, and expected the opposed and predictable increment of unnecessary cost as an
esteemed opposition of antibiotic use is not yet quantified. The main target was to conduct a
cost-effective analysis, approximating the fighting against antibiotics and designing the standards
for treating acute otitis media in children less than two years. Results were based on a similar
denominator and cost of struggle against antibiotics was approximated from a parental view.
Classes of Medicine
1. Drugs such as acetaminophen (Tylenol) and ibuprofen (Advil) are recommended for
adults to treat infections and inflammation pain in the ear.

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2. Decongestants or antihistamines, like pseudoephedrine (Sudafed) or diphenhydramine
(Benadryl), reduces some OM signs precisely the ones as a result of heap mucus in the
eustachian tubes and also Decongestants and antihistamines.
3. Tympanostomy tubes or Recurrent Acute Otitis Media), an antibiotic dosage is advisable
for patients with a pierced tympanic layer with suppuration secretions and those with
OME and a swollen TM.
4. Amoxicillin is highly recommended in cases where antibiotics are needed. It should be
used in incidences where simultaneous suppuration inflammation. (cefprozil or
cefuroxime) or cephalosporin (Ludman & Bradley, 2012).
Non- Pharmacological Treatments
Some of the lifestyles practices that prevent otitis media infections include the following:
Avoid smoking either passively or actively smoking as it significantly reduces upper respiratory
diseases and ear infections since it affects the immune system and also causes inflammation
Proper cleaning and drying habits of the outer part of the ear should be adopted, hands should not
be cleaned regularly to avoid the transferring germs into the year by also avoiding having hands
in or near the ear. However, cleaning hands using cotton swabs and other objects should be
avoided as it can damage the eardrum.
Allergic people should pay attention to what causes the allergy so as to decrease the tenancies of
inflammation and building up mucus that could lead to these illnesses. Seeking health care for
periodical allergies and skin infections can also help to prevent ear illnesses (Gosman, 2017).

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Specified botanic medicine
Eardrops
Eardrops are significant most especially in normal incidences like for a swimmer's ear. They
should not be used by clients with ear tubes (T-tubes), prevalent eardrum damages, and any
surgeries in the ear or discharging ears otherwise recommended by the specialists.
Compress
A compress that is lukewarm can aid in reducing the pain due to mechanic disruptions in the ear
by using it for about twenty minutes. This could be accompanied by other pain relievers from the
counter. (Balkany & Brown, 2017).
Recommendations
Otitis media is a relevant universal and pediatric health issue. Nevertheless, a few cases will
require to be attended to before otitis media awareness programs are initiated in the campaign
plans which includes standardized research, and appropriate reimbursement programs for the
significant coding system. Specific, the standards for proper usage of antibiotics which should be
transformed through high scientific techniques for easily and properly identifying ICD-9 codes
for OM infections that seriously needs the use of antibiotics. Most importantly, modifications in
innovation and development of health information technology for basic health care activities
with time the adoption of text mining system simplify and fasten the processes of proper process

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of identifying diagnosing and therapeutic services using the automated but secure medical
records for otitis media with effusion patients as recommended by (Haberman, 2011).
References:

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Adunka, O. F., & Buchman, C. A. (2011). Otology, Neurotology, and Lateral Skull Base
Surgery: An Illustrated Handbook. Thieme.
Balkany, T. J., & Brown, K. D. (2017). The Ear Book: A Complete Guide to Ear Disorders and
Health. Carolina: JHU Press.
Bas, S. (2017). Otitis: How To Treat Ear Infections. Silvia Bas.
Brackmann, D., & Arriaga, M. A. (2009). Otologic Surgery E-Book: Expert Consult - Online.
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Focus Medica Pte Ltd. (2008). Otitis Media: An Overview. International Pub Marketing.
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Gosman, G. H. (2017). I Have an Ear Infection. The Rosen Publishing Group.
Haberman, R. S. ( 2011). Middle Ear and Mastoid Surgery. Thieme.
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Kohan, D., & Chandrasekhar, S. (2014). Neurotology. Oxford University Press.
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Springer.

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Smith, R. (2014). Nurse-Infusion (CRNI) Self-Assessment: A Multiple Choice Practice Method
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