Globally, antibiotic use is of increasing concern in our era of expanding antibiotic resistance so there is an obvious question especially about ear infections, acute otitis media. If the outcome of research about using homeopathy is basically the same as the results of conventional medicine why are we not using Homeopathy instead?” Especially since there is no use of antibiotics required and there are no side effects from the homeopathic medicine. But firstly:

What is acute otitis media?

• Acute otitis media (AOM) is an infection of the middle ear.
• It is the second most common diagnosis in children visiting an emergency department.
• 80% of Australian children have been effected by the age of 3 years. 

Causes and risk factors of AOM

• Infectious, allergic, and environmental factors all contribute
• It can be viral, bacterial, or a co-infection
• Vitamin A deficiency
• Bacterial: Streptococcus pneumoniae, Haemophilus influenza, and Moraxella (Branhamella) catarrhalis
• Viral: Respiratory syncytial virus, influenza, parainfluenza virus, rhinovirus, and adenovirus
• Lack of breastfeeding
• Passive smoke exposure
• Air pollution
• Daycare attendance
• Family history of recurrent AOM in parents or siblings

Variable conventional medicine treatment approaches

• Treatment with antibiotics is controversial
• In Romania, clinicians recommend immediate antibiotic treatment in 98.03% of cases.
• In the USA, the mainstay of treatment for an established diagnosis of AOM is high-dose amoxicillin
• Treatment in the Netherlands is initially watchful waiting, and if unresolved, antibiotics are warranted
• 7.5% of cases in Australia and 55.2% of cases in Finland use a watchful-waiting approach 
• Large scale studies have found excessive and inconsistent antibiotic prescribing

What is the watchful waiting approach?

It means observing and watching how the child is doing for 2–3 days to give their immune system time to fight off the infection rather than starting antibiotics immediately. The healthcare professional waits to see if the child gets better before giving them a prescription for antibiotics. After two to three days of watchful waiting approximately 80% of children will spontaneously recover.

Research about the homeopathy approach for AOM treatment

In 2001, Jacobs published Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. It showed a positive treatment effect of homeopathy when compared with placebo in AOM.

This was followed in 2012 by Randomized controlled pilot study to compare Homeopathy and Conventional therapy in Acute Otitis Media. Symptomatic improvement was quicker in the Homeopathy group, and there was a large difference in antibiotic requirements, favouring homeopathy.

Homeopathic Ear Drops as an Adjunct in Reducing Antibiotic Usage in Children With Acute Otitis Media children diagnosed with acute otitis media (AOM) was published in 2014. The authors found that Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach.

There is a general conclusion by authors that further homeopathy research on a larger scale should be conducted. So it is of great importance to hear of the work conducted by Varanasi et al. in India on a large scale. This work was presented at the Homeopathy Research Institute conference 2023.

Presentation at the HRI Homeopathy Conference 2023

Dr Roja Varanasi at the Homeopathy Research Institute (HRI) conference 2023, described a recent randomised controlled trial of homeopathy compared to conventional treatment for acute otitis media (AOM) and its reoccurrence in children. The potential role of homeopathy in dealing with inflammatory disease was explored clinically with a focus on AOM. The research was A comparative randomised controlled trial vs allopathy (conventional medicine).

Dr Roja Varanasi presented at HRI 2023

It was a multi centre trial in five different locations in India so that different climate zones were included for example in Northern India where it is cooler and Southern India where it is warmer and humid.

Details of the AOM trial in India

• Multicentre trial with 5 institutes
• There was a one year follow up
• Children aged 2 to 12 years were included and those already given antibiotics in the last 7 days were excluded
• Individualised homeopathic medicine was given as treatment and compared to conventional medicine
• In the conventional medicine group the prescriptions were made by an ENT specialist: antibiotics for infection; analgesics for pain; antipyretics for fever; anti-inflammatories for inflammation; and decongestants for congestion
• Doctors prescribing homeopathic medicine had 15 years or more experience
• Repetition of the chosen homeopathic medicine was from 2 to 6 hourly or more often, as needed depending on the intensity of the symptoms
• Main remedies required were Pulsatilla, Arsenicum, Belladonna and Merc sol. which were 50% of the homeopathic prescriptions
• Potencies individually chosen included 6c, 30c, 200c and M

Outcome and conclusion

The outcome was that none of the children who received homeopathy needed antibiotics but in the conventional medicine group there were 14 children who needed antibiotics. Also the homeopathy group had much less reoccurrence when followed over one year.

There was statistically no difference between the two groups therefore Homeopathy is non-inferior to conventional medicine.

Globally, without any doubt, further improvements are needed in antibiotic stewardship in AOM in children. Antibiotic use is of increasing concern in our era of expanding antibiotic resistance so there is an obvious question. “If the outcome of the Homeopathy group was basically the same as the conventional medicine group why are we then not using Homeopathy instead?” Especially since there is no use of antibiotics required and there are no side effects from the homeopathic medicine.

Homeopathy can be sensibly and safely offered as a first line of treatment during a ‘watchful waiting’ period in the treatment of AOM in children.

Thank you to Dr Varanasi and her team for this work and the work of the HRI in the many excellent presentations in 2023.

Dr Roja Varanasi, BHMS, MD (Hom.), is currently working as Research Officer(H)/Scientist-3, in Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of India.

She is involved in various topics related to homeopathy. She has significantly contributed to the development of Standard Treatment Guidelines in Homoeopathy published by the Council.