News and Alerts

Antibiotics-Ear Infection Controversy Continues

Prescribing antibiotics at the first signs of acute otitis media (ear infection) in children between 6 months and 2 years old is not justified, according to a new study from the Netherlands.

Research on the use of and necessity of antibiotics in the treatment of inner ear infections is mixed, several studies ardently support its immediate use while others say it is unnecessary.

The latest study, published in a recent British Medical Journal, of 240 children was conducted between February 1996 and May 1998 in the Netherlands, where all patients are treated initially by their own general practitioner. Children aged between 6 and 24 months were eligible if they presented with acute otitis media & defined as infection of the middle ear.

According to the researchers, only eight children with acute otitis media need to be treated with amoxicillin to improve symptomatic outcome at day four of their symptoms. Additionally, duration of fever was two days in the amoxicillin group versus three in the placebo group. No significant difference was observed in duration of pain or crying, but analgesic consumption was higher in the placebo group during the first 10 days.

For more on the study and a bibliography of other antibiotics-ear infection studies, visit the British Medical Journal Web site.

Child Support Enforcement Breaks New Records

The federal and state child support enforcement program broke new records in nationwide collections last year, reaching $15.5 billion, nearly doubling the amount collected in 1992.

The federal government collected a new record amount of $1.3 billion in overdue child support from federal income tax refunds for tax year 1998, an 18 percent increase over the previous year and a 99 percent increase since 1992. Nearly 1.4 million families benefited from these collections.

In addition, a new program to match delinquent parents with financial records found 662,000 accounts since August 1999 with a value of about $1 billion.

"We are working harder than ever to ensure children get the support from both parents they deserve and need," said Secretary Shalala. "We make no apologies for using tough measures, but we also are striving to help those parents who can't meet their responsibilities find the means to do so. Every child deserves the financial and emotional support of both parents."

Under the federal tax offset program, state child support agencies report names of parents who owe child support payments and the overdue amount to the HHS Administration for Children and Families. These individuals are first notified by the state in a pre-offset letter of their overdue child support obligation. This gives them the opportunity to have their case reviewed for correctness before final submission to the U.S Treasury Department for action.

These individuals are then notified in writing by the U.S. Department of Treasury, Financial Management Services of the amount to be withheld to cover their child support debt. That amount is then deducted from their income tax refund. The delinquency may also be reported to credit reporting agencies.

A state by state list of the tax-offset collections and families served is available at: http://www.acf.dhhs.gov/news.

Pennsylvania Child Care Program Expanded

Thousands of Pennsylvania working families will pay less for the state's child-care program, according to Gov. Tom Ridge. Simultaneously, the program will be expanded so that more Pennsylvania working families qualify.

The state's child-care program now serves 105,000 families each year. Most of those families are required to pay between $5 and $25 a week for their child care. The state pays the rest, typically $75 to $95 a week per child. Gov. Ridge said his new budget will reduce the cost for all families who pay more than the $5-per-week minimum.

About 90,000 families will save between $20 and $65 per month as a result. Some families will save as much as $780 a year.

Gov. Ridge's proposed 2000-01 budget will invest $20 million in new funds to expand eligibility to more families and to reduce the cost for every family who pays more than the $5-per-week minimum. The Governor's budget also will invest an additional $20 million over the next two years to improve the quality and increase the capacity of child-care programs across the state.

The new guidelines will raise a family's income eligibility to enter the program from $25,253 for a family of three to $27,760 for a family of three. That same family would remain eligible for subsidized child care until its incomes go above $32,618.

Circumcision Causes Little Harm

Circumcision remains a relatively safe procedure. However, for some parents, the risks reported in a new study may outweigh the potential benefits.

Researchers at the Department of Pediatrics, University of Washington, found that infants who undergo the procedure have only a 1-in-476 chance of complications.

Of 354,297 male infants born during the study period, 130,475 (37 percent) were circumcised during their newborn stay. Overall 287 (.2 percent) of circumcised children and 33 (.01%) of uncircumcised children had complications potentially associated with circumcision coded as a discharge diagnosis.

The study, published in the January issue of Pediatrics, was developed after the American Academy of Pediatrics' announced last year that it no longer recommended routine circumcision because of questionable benefits and medical and anecdotal evidence that circumcised men have less penile sensitivity.

For more on the study, visit the Pediatrics Web site.

Make Chickenpox Vaccine Mandatory, Says AAP

The American Academy of Pediatrics is strongly urging pediatricians to support public health officials in developing and implementing chickenpox immunization requirements for child care and school entry.

The Varicella Vaccine Update reiterates the dangers of the disease as well as the need for universal immunization of healthy children over 12 months.

Before the availability of the vaccine in 1995, approximately four million cases of chickenpox were reported each year in the U.S. resulting in 10,000 hospitalizations and 100 deaths. Ninety percent of these infections, two-thirds of chickenpox-related hospitalizations, and almost half of chickenpox-related deaths occurred in children. Children with chickenpox are also more likely to contract severe, invasive, group A streptococcal disease. While few adults contract the disease, those who do have a 10 to 20-times higher risk of death and complications.

According to the AAP, the chickenpox vaccine has been proven to be extremely effective and safe. In controlled trials, the varicella vaccine was found to be about 85 percent effective for preventing all cases of chickenpox, and almost 100 percent effective in preventing severe cases. The vaccine can also be effective when administered within three days of exposure to chickenpox.

Chickenpox vaccine reactions are generally mild and occur with an overall frequency of approximately 5 to 30 percent.

For more on the announcement, visit the American Academy of Pediatrics' Web site.

Women More Active in Healthcare Roles

Women today are playing a much more proactive role in their oown healthcare and the gatekeeping duties for their families and aging parents, according to a new study.

Beta Research Corp., a full-service market research firm in Syosset, N.Y., recently unveiled "The Confidential Study Of Women's Health Issues," an intimate look at how women in the U.S. now act to control their own healthcare destinies and those of their loved ones.

A few examples of the findings include:

• 55% believe women's healthcare has generally improved over the last 5 years.
• 65% are more involved in their own healthcare compared to 5 years ago.
• 62% now research ailments or treatments that affect them or their families.
• 78% are now questioning their doctors' choice of treatments.
• 59% "would pay just about anything" when it comes to their health.
• And 46% feel that their family's healthcare needs come before their own.