YSPH's Melinda Pettigrew: Researching novel approaches to combat a common childhood infection

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Melinda M. Pettigrew

Otitis media, more commonly know to generations of parents and their children as an ear infection, is a painful fact of infancy, with nearly 80 percent of youngsters becoming infected by age 3.

While it is not fatal, the infection further strains a heavily burdened U.S. health care system as worried parents seek relief for their children’s acute suffering.

Yale School of Public Health Associate Professor Melinda M. Pettigrew is studying the infection’s underlying bacterial and viral origins and is looking at novel approaches — ones that do not necessarily involve the use of antibiotics — to reduce its incidence.

The disease is most often caused by bacteria and usually follows a respiratory virus infection. Doctors rely heavily on antibiotics as a remedy, prescribing them in approximately 80 percent of office visits.  But the use of antibiotics for ear infections is controversial, as over half of otitis media episodes resolve without antibiotic treatment and overprescribing antibiotics is driving antibiotic resistance, she said.

“The problem is that we can’t really determine who needs antibiotics and who doesn’t,” Pettigrew said during a recent seminar in the Laboratory of Epidemiology and Public Health during which she outlined some of her research interests.

The FDA, meanwhile, recently approved an enhanced vaccine that counteracts more strains of one of the major otitis media pathogens and this has helped to reduce the incidence. But this approach also has the potential to create its own problems, she said. Such targeted approaches may alter the epidemiology of other colonizing species and shift the prevalence of certain types of bacteria with unknown and unintended health consequences.

A better understanding of bacterial competition could lead to the development of novel means to intervene and prevent otitis media and other diseases. For instance, disrupting the signaling pathways that bacteria rely upon could potentially be a treatment approach, instead of relying on traditional antibiotics, Pettigrew said.

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Michael Greenwood: michael.greenwood@yale.edu, 203-737-5151