Tuesday, March 6, 2001; Page HE07

Apilot study suggests that homeopathic treatments can reduce fever, pain and irritability in the early stages of ear infection in children. But even if the research holds up in larger-scale trials, researchers will have a difficult time convincing mainstream practitioners of the technique's merits.

"Homeopathy is probably the least accepted alternative therapy among conventional physicians -- and one more study isn't going to change that," says Adriane Fugh-Berman, assistant clinical professor of health care sciences at George Washington University School of Medicine and author of "Alternative Medicine: What Works." Most recent, well-designed trials have shown negative results for homeopathy, she adds, including homeopathic treatments for warts in children and for radiation burns in breast cancer patients.

Homeopathic treatment is based on the theory of "like cures like." A substance that can cause certain symptoms when given in large doses to a healthy person is prescribed in very small doses to a sick individual in an effort to cure those symptoms. Remedies are tailored to the individual, based on symptoms.

A basic gripe against homeopathy is that despite anecdotal claims of its value for more than a century, it remains a scientifically unproven therapy that uses medicines often containing no detectable amount of active ingredient. Detractors -- and there are many -- consider homeopathic remedies to be nothing more than placebo and have rejected study after study as flawed and inconclusive.

Family physician Jennifer Jacobs of Seattle, principal investigator of the ear infection study, is trying to introduce more science into the emotional back-and-forth by conducting rigorous testing of homeopathy and publishing her findings in peer-reviewed journals.

Jacobs's latest effort, in February's issue of Pediatric Infectious Disease Journal, is a randomized, double-blinded study of acute otitis media, or inflammation of the middle ear, mostly using four homeopathic remedies, each normally indicated for a different set of symptoms. The results showed that children receiving homeopathy had a statistically significant reduction in symptoms in the first 24 hours after treatment, Jacobs says.

The best first-line of therapy for ear infections is not to reach for antibiotics but to strengthen the body's natural defenses, in this case by using homeopathic remedies, insists Jacobs, clinical assistant professor in the department of epidemiology at the University of Washington School of Public Health and Community Medicine. Increasingly, she says, pediatricians are taking a "watchful waiting" approach, using antibiotics only if infections don't clear up in a few days, as the vast majority do.

But Fugh-Berman says there were no significant differences in treatment failures (children withdrawn from the study because of severe ear pain and/or high fever) between the group getting homeopathic medicines and the placebo group. She also notes there wasn't a consistent difference between the groups in symptom relief: The homeopathic group had fewer symptoms at 24 hours, but more symptoms at 48 hours. She concludes the study "did not show impressive results for homeopathy."

Wayne Jonas, former director of the National Center for Complementary and Alternative Medicine at the National Institutes of Health, says Jacobs's study of 75 children 18 months to 6 years old, while rigorous science from an established researcher, "does not convince me otitis media should be treated with homeopathy. . . . This shouldn't change standard practice -- but it may offer us a new option for approaching otitis media if results are confirmed with a larger study," says Jonas, a family physician in Bethesda who uses some homeopathy in his practice.

Jacobs conducted the first double-blind study of homeopathy published in the United States, which found that homeopathic treatment helped children with mild diarrhea. Fugh-Berman calls it "a reasonably done trial" -- but the 1994 study is lambasted on the Web site www.quackwatch.com.

-- Judy Packer-Tursman