What Are Antibiotics Made Of
The first beta-lactam antibiotic, penicillin, was discovered by accident. It was growing from a blob of mold on a petri dish. Scientists found that a certain type of fungus naturally produced penicillin. Eventually, penicillin was produced in large quantities in a laboratory through fermentation using the fungus.
Some other early antibiotics were produced by bacteria found in ground soil.
Today, all antibiotic medications are produced in a lab. Some are made through a series of chemical reactions that produce the substance used in the medication.
Other antibiotics are at least partially made through a natural but controlled process. This process is often enhanced with certain chemical reactions that can alter the original substance to create a different medication.
Which Antibiotic Is Best For An Ear Infection
Two classes of antibiotics are commonly used to treat an infection.
Aminoglycosides
Aminoglycosides have been the main treatment for bacterial ear infections for decades. Two aminoglycosides used in ototopical preparations are:
- Neomycin
- Tobramycin
Though both of the above are commonly used in the United States, only neomycin has FDA approval. Neomycin is effective for gram-positive bacteria but its effectiveness against gram-negative bacteria has declined over years, especially against Pseudomonas, the most common bacteria in ear infections.
Tobramycin is effective for Pseudomonas and other gram-negative bacteria.
Quinolones
Quinolones are the most recently introduced ototopical antibiotics. Most quinolone antibiotics in use are fluoroquinolones, which also contain an atom of fluorine. Fluoroquinolones are considered the best available treatment now for ear infections for two reasons:
- Broad spectrum of activity against both gram-positive and gram-negative bacteria
- Lack of ototoxicity
Following are some of the FDA-approved fluoroquinolone solutions for external ear infection from Staphylococcus aureus and Pseudomonas aeruginosa:
Ciprofloxacin
What Are Symptoms Of Ear Infections
Symptoms of ear infections include:
Additional signs of ear infections in young children and infants may also include:
- Pulling on the ear/rubbing the ear
- Fussiness
Middle ear infection is usually caused by:
- Bacteria the most common bacterial causes include:
- Streptococcus pneumoniae
- Haemophilus influenzae
- Flu
Infections of the ear canal are usually caused by water that remains in the outer ear canal for an extended period of time, which, when combined with the earwax and debris already present in the ear canal, provided a moist environment for bacteria or yeast to grow and cause infection. While its commonly called swimmers ear, diving or bathing and showering can also permit just enough water into the ear to create a fertile breeding ground for infection.
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When Do Children Need Tubes In Their Ears
If your child has frequent ear infections, or if he has trouble hearing because of ongoing fluid in the middle ear, he may need a tube inserted through the ear drum and into the middle ear. The tube helps to keep air pressure normal on both sides of the ear drum and helps fluid drain from the middle ear.
Putting tubes in requires a brief operation by an ear, nose and throat surgeon. Children usually go home the same day.
What Causes Otitis Externa
Otitis externa is an infection of the skin of the ear canal and is very common. The ear canal is a narrow, warm, blind-ended tunnel, which makes it a good protected environment for germs to grow in if they are given a chance. Most infections are caused by a germ . Occasionally, they can be due to a fungal or yeast infection.
Some things can make you more prone to otitis externa for example:
Substances entering the earIf you regularly get water in an ear then this may provide moisture for germs to grow. It may also cause itching. You may then scratch or poke the ear. This can damage the skin in the ear canal and cause inflammation. Inflamed skin can quickly become infected. A vicious circle may then develop. The inflammation and infection cause more itch, you then scratch more, which then can makes things worse.
If you get shampoo, hairspray or other products into your ear this may have the same effect and may be worse, as the chemicals may additionally irritate the sensitive skin of the canal.
SwimmingOtitis externa is much more common in regular swimmers, due to water getting into the ear canal. In fact, otitis externa is sometimes called swimmers ear. It is more likely if you are swimming in water which isnt clean, such as ponds.
Warm weatherOtitis externa is more likely to develop in hot, humid and sweaty weather. It is more common in hot countries.
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Can Objects Bugs Or Insects In The Ear Cause Outer Ear Infections
Young children often will put foreign objects their ear by accident or while scratching or trying to clean their ear. Often, children who put objects in their ear also have swimmerâs ear . Do not try to remove objects stuck in the ear because it can be difficult. Call your pediatrician to have the object safely removed. Usually this can be done in the office, but sometimes, general anesthesia may be necessary to remove the lodged object if it is stuck deeply in the ear or if the child or adult is uncooperative.
Insects or bugs can be trapped in the ear, for example, small gnats can be caught and stuck in the earwax. Often, bugs and insects can washed out with warm water. Larger insects or bugs may not be able to turn around in the narrow canal. If the insect or bug is still alive, first kill it by filling the ear with mineral oil. This will suffocate the insect, and then see your doctor to have it removed.
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Cautions With Other Medicines
There are some medicines that do not mix well with amoxicillin.
Tell your doctor if youre taking any of these medicines before you start taking amoxicillin:
- methotrexate, used to treat arthritis and psoriasis
- warfarin, a medicine to prevent blood clots
- gout medicines called probenecid or allopurinol
- other antibiotics
Tell your doctor if youve recently had, or are due to have, an oral typhoid vaccine. Amoxicillin can make it less effective.
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Common Questions About Amoxicillin
There’s no evidence to suggest that taking amoxicillin reduces fertility in either men or women.
If you or your child take amoxicillin as a liquid medicine, it can stain your teeth. This does not last and should go after brushing your teeth well.
Amoxicillin capsules do not stain teeth.
Yes. Amoxicillin should not affect you being able to drive or cycle.
You can eat and drink normally while taking amoxicillin.
Yes, you can drink alcohol with amoxicillin.
How Do I Know If My Child Has An Ear Infection
Unfortunately, young children are often unable to communicate their discomfort, forcing parents to identify symptoms via a process of deduction. Most ear infections are preceded by a normal cold. Children may have a runny nose with clear drainage that begins to turn yellow or green at the first signs of infection. Ear infections can also cause many other symptoms usually a combination of at least two of the following:
- Fussiness and irritability, often appearing suddenly
- Grasping or pulling at the ear
- Interruptions in sleep patterns
- Low grade fever, usually 101º 102º F
- Changes in balance
- Verbal complaints of ear pain
- Difficulty hearing
- Drainage from the ear, often tinged with blood or pus
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Common Types Of Ear Infections
The two most common types of ear infections are in the middle ear or the outer ear.
An infection in the middle ear often follows a cold or respiratory problem. The infection moves to the ears through the eustachian tubes causing them to swell.
Infections in the outer ear sometimes referred to as swimmers ear are usually caused by an outside source such as water. If water sits in the ear for too long, it can cause the skin to break down and become a breeding ground for bacteria.
Seek medical attention immediately if you have nausea, dizziness, or vomiting along with ear pain. You may have a more serious issue with your inner ear.
What Conditions Cause Swimmers Ear
Conditions that can lead to swimmers ear include:
- Water that gets trapped in the ear canal, for example from swimming or showering often
- Loss of ear wax a natural protectant due to too much water entering the ear canal or removing too much wax when cleaning ears
- Injury to ear caused by putting objects into the ear, such as fingers, pen/pencils, paper clips, hair clips
- Swimming in polluted water
- Other skin conditions that affect the ear canal, such as eczema or psoriasis
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Why Are Children More Likely Than Adults To Get Ear Infections
There are several reasons why children are more likely than adults to get ear infections.
Eustachian tubes are smaller and more level in children than they are in adults. This makes it difficult for fluid to drain out of the ear, even under normal conditions. If the eustachian tubes are swollen or blocked with mucus due to a cold or other respiratory illness, fluid may not be able to drain.
A childs immune system isnt as effective as an adults because its still developing. This makes it harder for children to fight infections.
As part of the immune system, the adenoids respond to bacteria passing through the nose and mouth. Sometimes bacteria get trapped in the adenoids, causing a chronic infection that can then pass on to the eustachian tubes and the middle ear.
When Is Treatment With Antibiotics Necessary For An Ear Infection
If your child is in a lot of pain, and the symptoms last more than a few days, your pediatrician will likely recommend a round of antibiotics. According to the AAFP, here are some of the circumstances where antibiotics are likely to be prescribed for an ear infection:
- Infants six months or younger.
- Babies ages six months to two years, who have moderate to severe ear pain.
- Children 2 years or older who have a fever of 102.2 or higher.
- Children with another condition that could make an infection harder to heal, including cleft palate, Down syndrome, immune disorders and cochlear implants.
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What Causes Acute Otitis Media
Acute otitis media usually is caused by one of four bacteria:
The pneumococcus bacteria is now the most difficult to treat. Some strains have become very resistant to antibiotics by using their unique ability to transform their genes and cell wall into a bacterial form, which is resistant to most of the antibiotics that commonly are used to treat ear infections. These resistant strains frequently are cultured from children who do not respond to several courses of antibiotics. When a child has an ear infection that does not respond to antibiotics, resistant pneumococcus bacteria may cause it.
Pneumococcus has 90 different types, which are all genetically related however, 7 types account for the majority of ear infections in childhood and nearly all of the antibiotic resistant strains. In addition, pneumococcus is the leading cause of meningitis, bloodstream infections, and serious pneumonia in children, sometimes as a result of a preceding ear infection.
Up to half of Haemophilus and nearly all Moraxella bacteria produce an enzyme , which makes these bacteria resistant to some of the commonly used antibiotics. This enzyme may destroy many antibiotics when they come in contact with the bacteria. Nonetheless, several available antibiotics are still quite effective against these strains.
Which Ear Drops Help In The Treatment Of Outer Ear Infections
Some prescription-only ear drops can effectively relieve earache caused by an outer ear infection . There is no evidence that over-the-counter disinfectant ear drops are as effective.
Outer ear infections are among the most common causes of earaches. They are usually caused by bacteria. If the infection only lasts a few days or weeks, it is called acute otitis externa. Painkillers and disinfectant ear drops are some of the more common treatments that are available in pharmacies without a prescription. But prescription-only ear drops for instance, containing antibiotics or steroids are often used too.
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Dangers Of An Unresolved Dental Abscesses
Leaving an abscess untreated will lead to serious medical complications in addition to severe pain. The infection will spread to other parts of your body, including your brain and nearby organs.
A dental abscess infection that travels to the brain is very difficult to treat because of the blood-brain barrier. Its also common for infections to spread into the sinuses.
An infection in your teeth or gums might indicate that you have heart health problems. Researchers believe gum disease is linked to heart disease and heart attack risk.
The infection can also spread to the surrounding bones. Facial bones are especially intolerant to infection. There is a high risk that bone removal will be needed to stop the further spread of the infection.
Even if you have a mild abscess, it can spread and weaken the bones, which creates problems in the future for your teeth.
An untreated abscess also poses a risk for tooth loss. Usually, a root canal and crown are enough to save the affected tooth. However, left untreated, theres a high likelihood your dentist will need to pull the tooth.
One of the most serious issues linked to untreated dental abscesses is . This is an infection in the bloodstream and it puts your entire body at risk.
If the abscess is not treated in time and it ruptures, the infection can spill into your blood and circulate throughout your body. and requires IV antibiotic treatment and long-term hospitalization.
Summary
Types Of Ear Infection
The most common type of ear infection is called acute otitis media . Symptoms include earache, drainage and fever. AOM is especially common in children because their Eustachian tubes, which equalize pressure and allow fluid to drain, are much shorter and more horizontal than adults.
Other common types of ear infection include:
- Otitis media with effusion , which means the infection has passed but fluid remains in the middle ear.
- Chronic otitis media with effusion , which entails fluid becoming built-up on a recurring basis but without bacteria this long-term condition can lead to hearing loss, especially in children.
- Swimmers ear , which happens when water becomes trapped in the ear canal and becomes infected.
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How To Take It
Try to space the doses evenly throughout the day. If you take it 3 times a day, this could be first thing in the morning, mid-afternoon and at bedtime.
You can take amoxicillin before or after food.
Swallow amoxicillin capsules whole with a drink of water. Do not chew or break them.
Amoxicillin is available as a liquid for children and people who find it difficult to swallow capsules.
If you or your child are taking liquid amoxicillin, it will usually be made up for you by your pharmacist. The medicine will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.
What Causes Ear Infections
An ear infection is usually a complication of a cold. It occurs when a cold causes swelling and blockage of the eustachian tube, so that fluid builds up in the middle ear and becomes infected. Infants and toddlers have shorter and more angled eustachian tubes than older children this makes them more prone to otitis media. Most children outgrow the tendency to develop ear infections by the time they are 4 years old.
Breastfeeding an infant lowers the risk of ear infections. Certain other things increase the risk. These include:
- Exposure to frequent viral infections in day care
- Exposure to secondhand cigarette smoke
- Use of pacifiers
- A family history of frequent ear infections.
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How Can I Tell If My Child Has An Ear Infection
Most ear infections happen to children before theyve learned how to talk. If your child isnt old enough to say My ear hurts, here are a few things to look for:
- Tugging or pulling at the ear
- Fussiness and crying
- Fever
- Fluid draining from the ear
- Clumsiness or problems with balance
- Trouble hearing or responding to quiet sounds
Should My Child See Her Pediatrician For An Ear Infection
In some cases with older babies and toddlers, mild symptoms may go away on their own. But if your child is under 6 months old, has a high fever, severe pain, drainage or swelling in the ear, its time to call your pediatrician. However, your doctor wont necessarily prescribe antibiotics right away. Ear infections are caused by both bacteria and viruses, so antibiotics arent always the solution. According to the American Academy of Family Physicians, there are several reasons why doctors dont prescribe antibiotics for every ear infection:
- Antibiotics dont work for ear infections caused by viruses.
- Antibiotics dont help the pain associated with ear infections
- Infections from both viruses and bacteria often disappear without antibiotics in a few days, especially in children over two years old.
- Physicians are keenly aware that the overprescription of antibiotics makes vital medicines less effective, so we work hard to use them only when truly necessary. In many cases, your doctor will watch the infection for a few days to see if it goes away on its own.
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