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Australian Journal of Pharmacy : November 2005
Flu vaccine study ear, nose and throat T HE first comprehensive study to investigate if the flu vaccination could prevent otitis media and other infections in children, will begin in Sydney next year. Pediatrician Professor Robert Booy, from the Children’s Hospital at Westmead, Sydney, and co-director for the National Centre for Immunisation Research (NCIR), told the AJPmore than 2,000 children, aged from six months to three years from community and day-care centres, will be involved in the two-year study which begins in autumn 2006. ‘The goal of the research is to not only examine the possible benefits of the flu vaccine to children in terms of otitis media, chest infections, antibiotic prescriptions and hospitalisations, but also at preventing illness occurring in their parents and the wider community. ‘There are some studies showing that up to a third of cases of otitis media in the height of winter could be caused by influenza. So the flu vaccine might be helpful in that respect.’ Augmentin but the big story really is: do you need antibiotics?’ ‘If the GP has diagnosed and clearly seen a red ear and advised that the con- dition will improve without antibiotics within the next four or five days and pre- scribing antibiotics is not justified, then that is fine. ‘In the main, this course of action is appropriate because antibiotics are not necessary. There will, however, be the occasional case where the GP says it is oti- tis media, and there is a fever and if it is not treated with antibiotics this could be a mistake if bacteraemia is present. ‘These are the cases that slip through the net and do need antibiotic treatment. Although these events are on the periph- ery it remains a real concern.’ The answer to this, he claims, is the ongoing training of doctors in general practice. And pharmacy’s role? Pharmacy’s role in all of this, said Dr Elsworth, is to advise parents of a child with ongoing ear problems to see their GP: ‘Make them aware of the need to talk to the family doctor if there is persistent ear- ache, because a lot of middle-ear infection is sub-acute and does not draw attention to itself as such and the child does not always draw attention to the problem either. ‘Persistence results in deafness, speech and learning delay, as well as predispos- ing the child to complications of otitis media, for example, mastoiditis. ‘Pharmacists should make sure medica- tion, either as one or preferably two courses of antibiotics, is taken properly and the patient returns to the GP to make sure all is back to normal after completion of treatment.’ Decongestants, he said, are not very helpful. Paracetamol or Painstop are appropriate for pain relief if necessary. Professor Booy said parents frequently speak to the pharmacist before they visit a doctor for a child with a fever who might have otitis media. ‘So, it is important that the pharmacist recognises the child who is very sick and a child who is not and advises a GPbe con- sulted when symptomatic treatment will not be enough. ‘It is quite important that both parents and professionals, be they doctors or pharmacists, recognise the ill child. There is certainly a need for greater education across the board of professionals—both pharmacists and doctors—in order that antibiotics are prescribed at the appropri- ate time. And as for the possible looming threat of bird flu, Professor Booy said it would be important to test children with the proto- type bird flu vaccines being produced. ‘People should be giving serious con- sideration to see how we can use the vac- cine in children because children are the ones who spread disease very easily.’ ¦ 886 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 NOVEMBER 2005