Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions

Abstract

Children with acute respiratory or ear infections (RTI/OM) are often unnecessarily prescribed antibiotics. Antibiotic resistance is a major public health problem and antibiotic prescription for RTI/OM should be reduced. Anthroposophic treatment of RTI/OM includes anthroposophic medications, nonmedication therapy and if necessary also antibiotics. This secondary analysis from an observational study comprised 529 children <18 years from Europe (AT, DE, NL, and UK) or USA, whose caregivers had chosen to consult physicians offering anthroposophic (A-) or conventional (C-) treatment for RTI/OM. During the 28-day follow-up antibiotics were prescribed to 5.5% of A-patients and 25.6% of C-patients (P < 0.001); unadjusted odds ratio for nonprescription in A- versus C-patients 6.58 (95%-CI 3.45–12.56); after adjustment for demographics and morbidity 6.33 (3.17–12.64). Antibiotic prescription rates in recent observational studies with similar patients in similar settings, ranged from 31.0% to 84.1%. Compared to C-patients, A-patients also had much lower use of analgesics, somewhat quicker symptom resolution, and higher caregiver satisfaction. Adverse drug reactions were infrequent (2.3% in both groups) and not serious. Limitation was that results apply to children of caregivers who consult A-physicians. One cannot infer to what extent antibiotics might be avoided in children who usually receive C-treatment, if they were offered A-treatment.

Fever: Views in Anthroposophic Medicine and Their Scientific Validity

“…Of these (see also Figure 1),59 publications discussed or referenced either studies examining the connection between atopy and children living an “anthroposophic lifestyle” (the seminal study being the Lancet article by Alm et al [7]), or studies where such a lifestyle impacted on low immunization levels in various communities,10 publications discussed or reported the fever-inducing effect of anthroposophic cancer remedies containing Viscum album , some of which discussing fever as part of the anticancer action of Viscum album extracts,8 publications discussed or referenced other or general aspects of AM not directly related to the management of fever,10 publications expressed anthroposophic opinions about fever, including a focus group study of factors that influence vaccination decision-making by parents who visit an anthroposophical child welfare center [7, 8, 23–30]. …”

“…10 publications expressed anthroposophic opinions about fever, including a focus group study of factors that influence vaccination decision-making by parents who visit an anthroposophical child welfare center [7, 8, 23–30]. …”

“…It is, however, worth mentioning that human “warmth,” the most powerful personality trait in social judgment, is enhanced by physical warmth [43, 44]. “Fever may allow faster and/or more complete resolution of infections” [8, 19–23, 26–29]. …”

“…They summarize “large studies seem to indicate that fever phobia persists and antipyretic drugs are still overused [2–4]. Considering that we do seem to have failed in part to provide effective guidance to parents, how did this happen?” The present review is about a cultural strain within medicine that is very successful in turning fever phobia into what could be called “fever philia”: in large hospitals [5] and thousands of practices [6] physicians and nurses interested in anthroposophic medicine have, for decades, met their patients with a contagiously appreciative attitude towards the phenomenon of fever [7, 8]. This results in a very low use of antipyretics and, perhaps more importantly, of antibiotics (5-6% in airway infections) [7–9].…”

Integrative versus Conventional Therapy of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children: A Prospective Observational Study

“…However, it has not been formally investigated in the complex setting of chronic otitis media. Integrative medicine often involves the use of anthroposophic medications that are safe and usually well tolerated [14,15]. Specifically, extracts such as Cydonia fructus glycerinum and citrus lemon fructus have been used in clinical practice for decades [16].…”