How Are Middle Ear Infections Treated
Dr. Wang: Frontline treatment for middle ear infections is a course of oral antibiotics. Sometimes steroids can be added if the pain is severe, which doesn’t help resolve the infection any faster but can reduce the inflammation and pressure causing the pain. If you’ve been on standard treatments for several days but your ear still aches or feels full, you should be referred to an ENT, who may recommend different medications or elect to lance the eardrum to remove the fluid. If you keep getting middle ear infections, you may have to have ear tubes placed in your ears, just like we do with children.
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.
Chronic Ear Infection In Children
However, some children seem to get ear infections a lot more often than others. The infections might last for longer or reappear very quickly. Sometimes the same infection persists, without responding to the normal treatments.
The most likely cause of persistent ear infection in children is chronic otitis media. Persistent ear problems in children often happen because there is a build-up of fluid in the inner ear. The Eustachian tube isnt draining this fluid properly. This often happens because there is an infection that isnt responding to normal treatments. Fluid can also remain in the middle ear or keep coming back after the infection has gone, which means that the symptoms will persist.
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Other Reasons For Ear Pain
- Earwax. If you frequently attempt to remove the wax in your ear canal, you may actually be pushing the wax further into the canal. This can result in the canal becoming plugged. Such impacted earwax can cause pressure, ringing in the ear, vertigo, or a feeling of fullness. Your doctor can use special instruments to rinse out the ear canal and remove the plug of wax.
- Tooth. A painful tooth is sometimes mistaken for an ear infection. Thats because tooth pain often radiates up into the jaw, which is very close to the ear, says Jamison.
- Mastoiditis. An inflammation of the mastoid bone, which is located behind your ear, can cause pain and be mistaken for an ear infection. Although rare, mastoiditis is serious and requires treatment by a primary care provider or ear, nose, and throat specialist.
- Ruptured eardrum. A ruptured eardrum can result in ear pain and hearing loss. Possible causes include a change in pressure from air travel or scuba diving, a blow to the ear, a loud blast of noise, or an object pushed into the ear. Consult your physician if you think you may have ruptured an eardrum.
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.
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Alternative And Complementary Therapies
There are no effective alternative or complementary methods or therapies for curing a kidney infection.
But there may be ways you can increase your comfort while being treated with antibiotics, such as placing a heating pad on your abdomen, back, or side to ease any pain in those areas.
Drinking plenty of fluids can also help flush the bacteria causing the infection from your system.
And getting plenty of rest will help in your recovery from the infection.
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Know The Reason Why Do Doctors Prescribe Antibiotics For Viral Infections
Common cold and flu can occur atanytime of the year. Most of the times over the counter drugs and a little rest can cure viral fever. Sometimes, your own medication may not work properly to relieve you from the illness. At such times, many people in India think that antibiotic medicines could do the benefit and they often take antibiotic medicines without even consulting the physician.
It is advised that if a fever lasts longer than the expected time, you must consult your doctor. It is not always necessary that the fever is caused due to viral infections only. You may need some combination of medicines to be able to cope with your illness. Taking on antibiotic medication all by yourself is the last thing you would like to do if you know the dangerous side effects antibiotics could cause to your body when taken unnecessarily. The medicines that help in curing the symptoms are those that help in relieving pain like ibupofen, Dolo 650 and aspirin. Dolo 650 is a mild analgesic that helps in curing fever and relieves pain associated with back pain, arthritis and dental ache. Its main ingredient is paracetamol that eases pain.
What is Antibiotics Meant for?
Why Antibiotics can be Dangerous If Used in Treating Viral Infection?
When to Use Antibiotic Medicines?
Treatment of Viral Infections
Why Do Doctors Prescribe Antibiotics to Treat Viral Infections?
What to do When Doctor Prescribes Antibiotic for Viral Infection?
Misuse of Antibiotic Medicines
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How Can I Avoid Needing Ear Tubes
The best way to avoid needing ear tube surgery is to prevent ear infections. Because bacteria and viruses cause many ear infections, practicing good hygiene is a step toward prevention.
To prevent infection, do the following:
- Avoid people who are sick with a viral or bacterial illness
- If your child needs daycare, choose one with the fewest children
- Get an annual flu shot
- Receive other vaccinations as recommended both kids and adults
- Wash your hands before and after eating, after using the restroom, after touching shared or public surfaces, and before touching your eyes, nose, mouth or face
Additionally, to keep young children from suffering ear infections, never put them to bed with a bottle and wean them off a pacifier as soon as possible. And if you smoke, stop. Smoking and secondhand smoke increase the risk of ear infections for adults and children alike.
Do you or your little one experience frequent ear infections?
The ear, nose and throat specialists at the University of Maryland Medical System are ready to help put ear infections in the past.
Outer Ear Infection Treatment
The first step in treating an outer ear infection is to carefully clean the affected area. After cleaning, you should apply both antimicrobial and an anti-inflammatory medications to the ear.
A doctor may prescribe antibiotics if they believe the infection is bacterial. If the infection is viral, you will need to continue tending to the irritation on the ear and wait for the virus to resolve itself. Depending on the type of virus, more specialized treatment could be necessary.
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How Is An Ear Infection Treated
Treatment of ear infections depends on age, severity of the infection, the nature of the infection and if fluid remains in the middle ear for a long period of time.
Your healthcare provider will recommend medications to relieve you or your childs pain and fever. If the ear infection is mild, depending on the age of the child, your healthcare provider may choose to wait a few days to see if the infection goes away on its own before prescribing an antibiotic.
Antibiotics may be prescribed if bacteria are thought to be the cause of the ear infection. Your healthcare provider may want to wait up to three days before prescribing antibiotics to see if a mild infection clears up on its own when the child is older. If your or your childs ear infection is severe, antibiotics might be started right away.
The American Academy of Pediatrics has recommended when to prescribe antibiotics and when to consider waiting before prescribing based on your childs age, severity of their infection, and your childs temperature. Their recommendations are shown in the table below.
American Academy of Pediatrics Treatment Guide for Acute Otitis Media
|in one or both ears
|Mild for < 48 hours and temp < 102.2° F
|Treat with antibiotic OR observe. If observe, start antibiotics if child worsens or doesnt improve within 48 to 72 hours of start of symptoms
How To Help Prevent Ear Infections
While most children get ear infections, there are a few things parents can do to try to prevent them:
- Breast feeding infants until at least age 6 months may help to lessen the number of ear infections.
- Keep your child away from cigarette smoke. Do not smoke or allow smoking in your home or car.
- Always hold your baby with his head up during feeding time . Babies should not be fed by propping the bottle or while lying flat.The formula can get into the middle ear and cause an infection.
- Do notleave a bottle in the crib for the baby to drink at bedtime.
- Make sure your childs immunizations are up to date.
- If your child is diagnosed with acute otitis media, avoid giving him a pacifier.Dress your child properly in cold and rainy weather.
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Keep Your Ears Clean And Dry
Proper hygiene also can help keep your ears healthy. After showering, use your finger and a tissue. You can even use a blow-dryer, while youre drying your hair. But, never use a cotton swab, according to Oghalai.
It takes out about half the earwax and pushes the other half in very deep, where it is really hard to get it out, he says. Earwax naturally comes out in the shower, and most people have no need to worry about buildup.
Medical Treatment In Children
Doctors often take a wait-and-see approach when treating ear infections in children to avoid over-prescribing antibiotics, which can lead to antibiotic resistance.
A doctor may sometimes write you a prescription for antibiotics if symptoms are severe or dont resolve within 2 to 3 days. Alternatively, they may write you a prescription but recommend waiting first to see if your childs symptoms get better after 2 to 3 days.
Its important to finish your entire prescription. Often, a 7- or 10-day prescription of amoxicillin is prescribed.
You shouldnt give children aspirin without their doctors instruction. Aspirin is a preventable risk factor for developing Reyes syndrome, a rare disorder that causes brain and liver damage.
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Inner Ear Infection Treatment
Inner ear infections are very uncommon and usually go away on their own, but medications can help manage the symptoms if they ever do occur. Some options for managing the symptoms include vestibular therapy, which focuses on improving balance, over-the-counter antihistamines , or prescription medications like involuntary nervous system blockers , and sedatives.
What Happens During Ear Tube Placement
Ear tube surgery has traditionally been performed on children under general anesthesia. This means the patient is fully unconscious throughout the procedure.
Now, adults and young children may undergo the procedure with local anesthesia. With this type of anesthesia, only the eardrum is numbed. Once the anesthesia is administered, the surgeon makes a tiny incision in the eardrum. Any fluid from the middle ear is drained, and the surgeon inserts small ear tubes made of plastic or metal. These tubes are left in place. Their purpose? To maintain normal air pressure in the middle ear, keep it from clogging and prevent future infections.
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What Are The Symptoms Of An Ear Infection
There are three main types of ear infections. Each has a different combination of symptoms.
- Acute otitis media is the most common ear infection. Parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum. This causes pain in the earcommonly called an earache. Your child might also have a fever.
- Otitis media with effusion sometimes happens after an ear infection has run its course and fluid stays trapped behind the eardrum. A child with OME may have no symptoms, but a doctor will be able to see the fluid behind the eardrum with a special instrument.
- Chronic otitis media with effusion happens when fluid remains in the middle ear for a long time or returns over and over again, even though there is no infection. COME makes it harder for children to fight new infections and also can affect their hearing.
Home Remedies For Ear Infection In Adults
For Outer Ear Infection
Combine 1 part of white vinegar and 1 part of rubbing alcohol, pour 1 teaspoon of mixture into affected ear and let it drain back out. This solution can prevent the growth of bacteria and help to promote drying.
For Middle Ear Infection
- Warm compress: Place a warm compress over the affected ear to reduce the pain in the ear. That can be a warm bottle of water or a moist washcloth.
- Salt: Salt is one of the most effective home remedies. Heat one cup of salt in the microwave for around 5-6 minutes. Once it is done, place the hot salt into a sock or glove. Tie the open end of the sock or the glove utilizing a rubber band. Lie down and put the remedy under the infected ear for around 10-15 minutes. The heat from the hot salt will help to drain out the fluid from your ear.
- Apple cider vinegar: Apple cider vinegar is helpful in treating fungal ear infection. Mix 1 part of water and 1 part of vinegar, take a cotton ball and soak it in the mixture. Place the cotton ball in the infected ear for around 5 minutes. Repeat the procedure few times a day.
Watch the video below to learn more home remedies of ear infection:
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The Pain Doesnt Go Away
The pain from an ear infection will come on fast, but it doesnt usually last longer than a day or two. But if your pain lingers without improving for several days, you should head over to the doctor.
Depending on the severity of your ear infection, they may or may not prescribe you any antibiotics. If they do, make sure you continue taking your daily amount even if your pain is gone.
Treating Middle Ear Infections
You may be prescribed antibiotics. Some antibiotics may be taken orally. Others can be applied directly to the site of the infection with ear drops. Medications for pain, such as over-the-counter pain relievers and anti-inflammatory drugs may also be used to manage your symptoms.
Another helpful technique is called autoinsufflation. Its meant to help clear your eustachian tubes. You do this by squeezing your nose, closing your mouth, and very gently exhaling. This can send air through the eustachian tubes to help drain them.
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Are There Any Dangers Or Potential Complications
Myringotomy with insertion of ear tubes is an extremely common and safe procedure with minimal complications. When complications do occur, they may include:
- PerforationThis can rarely happen when a tube comes out or a long-term tube is removed and the hole in the ear drum does not close. The hole can be patched through a surgical procedure called a tympanoplasty or myringoplasty.
- ScarringAny irritation of the ear drum , including repeated insertion of ear tubes, can cause scarring called tympanosclerosis or myringosclerosis. In most cases, this causes no problem with hearing and does not need any treatment.
- InfectionEar infections can still occur with a tube in place and cause ear discharge or drainage. However, these infections are usually infrequent, do not cause prolonged hearing loss , and may go away on their own or be treated effectively with antibiotic ear drops. Oral antibiotics are rarely needed.
- Ear tubes come out too early or stay in too longIf an ear tube expels from the ear drum too soon , fluid may return and repeat surgery may be needed. Ear tubes that remain too long may result in perforation or may require removal by an otolaryngologist.