But Will It Still Work
In most cases, yes! Thats why the guidelines for treating ear infections changed in 2013.However, each childs situation is unique, and your familys medical provider is the best personto decide how long your child should take an antibiotic for an ear infection. On the other hand, ifyour child is over the age of two and has a non-severe ear infection, it makes sense to ask yourprovider about the possibility of a shorter course of treatment.
As always, talk to your doctor if you have other questions or concerns, and always follow thedirections on your childs medication.
You can read the full AAP clinical practice guideline for treating ear infections here.
If you are a medical provider, please consider taking our 5-minute survey.
Cold And Allergy Remedies
Recent research has questioned the general safety of cough and cold products for children. They are currently banned for use in children under age 4 years. The American College of Chest Physicians recommends against the use of nonprescription cough and cold medicines in children age 14 years and younger.
What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to give your child antibiotics
Reasons to wait and see
I’m not worried about the risk of side effects from antibiotics.
I’m worried that my child could have side effects from antibiotics.
I want to get my child’s infection taken care of now.
I’m willing to wait a couple of days for the infection to go away on its own.
I’m not concerned that using antibiotics a lot could make them not work in the future.
I’m concerned that antibiotics might not work in the future if my child uses them a lot.
I don’t want to spend money on medicine my child may not need.
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Ear Infection Types Causes And Symptoms
When it comes to an ear infection, there are a few different types of infections, and each has its own set of symptoms.
- Middle Ear Infection:acute otitis media is a middle ear infection that can be quite painful. Another middle ear infection, otitis media with effusion, occurs when fluid builds up in the middle ear, but does not cause ear pain, fever, or pus build-up.
- Causes: A middle ear infection can be caused by bacteria such as Haemophilus influenzae or streptococcus pneumoniae. Viruses can also cause an ear infection.
- Symptoms: The most common symptoms of acute otitis media in children include fever, ear pain, difficulty sleeping, rubbing or tugging at an ear, fussiness or irritability.
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Should I Use Antibiotics For An Ear Infection
Antibiotics are a medicine prescribed by your doctor. If youre dealing with an ear infection caused by bacteria, youll likely need antibiotics. They are the best way of quickly getting rid of a bacterial infection and preventing it from spreading to other parts of the body.
The catch is that antibiotics dont work against viruses if you use antibiotics on a viral ear infection, it can actually make the infection worse. Overuse of antibiotics can lead to a condition called antibiotic resistance, which means that the medicine becomes less effective at fighting off bacteria.
Thats why doctors are careful about using antibiotics wisely and may not immediately prescribe them for ear infections.
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What Are Complications Of Ear Infections
Complications of ear infections are uncommon with proper treatment. Complications may include:
- Hearing loss: usually temporary but may become permanent if the eardrum or middle ear structures are damaged
- Infection that spreads to nearby tissues, such as infection of the mastoid bone, which helps drain middle ear fluid
- Eardrum tears: most will heal on their own within a few days, though in some cases surgery is needed to repair it
- Speech or developmental delays in infants and toddlers if hearing is impaired
Infections Inside The Ear
Antibiotics are not usually offered because infections inside the ear often clear up on their own and antibiotics make little difference to symptoms, including pain.
Antibiotics might be prescribed if:
- an ear infection does not start to get better after 3 days
- you or your child has any fluid coming out of the ear
- you or your child has an illness that means there’s a risk of complications, such as cystic fibrosis
They may also be prescribed if your child is less than 2 years old and has an infection in both ears.
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When Not To Use Antibiotics
Antibiotics are not the correct choice for all infections. For example, most sore throats, cough and colds, flu, COVID or acute sinusitis are viral in origin and do not need an antibiotic. These viral infections are self-limiting, meaning that your own immune system will usually kick in and fight the virus off.
Using antibiotics for viral infections can increase the risk for antibiotic resistance. Antibiotic-resistant bacteria cannot be fully inhibited or killed by an antibiotic, even though the antibiotic may have worked effectively before the resistance occurred. This can also lower your options for effective treatments if an antibiotic is needed eventually due to a secondary infection. Using unnecessary antibiotics also puts you at risk for side effects and adds extra cost.
It’s important not to share your antibiotic or take medicine that was prescribed for someone else, and don’t save an antibiotic to use the next time you get sick. It may not be the right drug for your illness.
To better understand antibiotics, its best to break them down into common infections, common antibiotics, and the top antibiotic classes as listed in Drugs.com.
What Should I Expect If I Or My Child Has An Ear Infection
Ear infections are common in children. Adults can get them too. Most ear infections are not serious. Your healthcare provider will recommend over-the-counter medications to relieve pain and fever. Pain relief may begin as soon as a few hours after taking the drug.
Your healthcare provider may wait a few days before prescribing an antibiotic. Many infections go away on their own without the need for antibiotics. If you or your child receives an antibiotic, you should start to see improvement within two to three days.
If you or your child has ongoing or frequent infections, or if fluid remains in the middle ear and puts hearing at risk, ear tubes may be surgically implanted in the eardrum to keep fluid draining from the eustachian tube as it normally should.
Never hesitate to contact your healthcare provider if you have any concerns or questions.
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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
- Fluid draining from the ear
- Clumsiness or problems with balance
- Trouble hearing or responding to quiet sounds
Are There Other Signs I Should Watch For
Vomiting and nausea may occur during the acute phase of otitis interna. If the facial nerve, which is located in the area of the inner ear, is damaged by an inner ear infection, your dog may develop some of the following symptoms:
- drooling from the side of the mouth
- difficulty eating and dropping food
- inability to blink
- development of dry eye in the unblinking eye or Dry Eye in Dogs)
- eye discharge
- drooping of the eyelids, lips, and nostrils on the affected side
- signs of Horners syndrome which include uneven pupil size, called anisocoria, prominent third eyelid, and drooping upper eyelid on the affected side
With long-term facial nerve paralysis the face may actually twist toward the side of the ear infection.
Additional signs include redness in the affected ear and discharge with a foul odor. The outer ear canal may become thickened and hard to the touch from chronic inflammation and the lymph node at the base of the chin on the affected side may become enlarged. Your dog may become reluctant to move at all, preferring to sit or lay in one spot and his head may swing from side to side, even at rest. You may also notice short, rapid, side-to-side movements of the eyeballs called nystagmus.
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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.
Remedies For Inner Ear Infections
Do you need antibiotics?
If you have a bacterial inner ear infection, you may need an antibiotic. However, most inner ear infections are caused by viruses, not bacteria. Antibiotics arent effective against viral infections. For viral infections, your doctor will suggest treatment options to control your inflammation and help with your symptoms.
What treatments can help?
If you have a viral inner ear infection, your doctor may prescribe a steroid treatment to reduce inflammation or antiviral medication to attack the virus.
What are some inner ear infection home remedies?
Besides medication, there are steps you can take at home to ease the symptoms of an inner ear infection. For example:
- Keep your head upright as much as possible. Sitting or standing can help to drain the ear.
- Apply a warm compress to the affected ear to relieve pain.
- Avoid smoking and drink as little alcohol as possible.
- Reduce your stress levels, since tension can worsen symptoms.
For labyrinthitis, specifically, to combat dizziness and nausea, you can try:
- Resting in a dark, quiet place
- Drinking plenty of water, especially if your nausea leads to vomiting
- Keeping your vision focused in one place instead of glancing around at your surroundings
- Going for walks as soon as you feel you can, with someone for support until you get your balance back
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How Well Do Antibiotics Clear Up Ear Infections
Antibiotics work most of the time to treat ear infections caused by bacteria. But they won’t treat ear infections caused by viruses.
No matter what causes the infection, most children 6 months and older won’t need antibiotics. Up to 80 out of 100 ear infections get better on their own, while 20 out of 100 don’t.footnote 2
You can help ease your child’s pain at home, whether you use antibiotics or wait for the ear infection to get better on its own.
- Give your child an over-the-counter pain reliever like acetaminophen or ibuprofen . Read and follow all instructions on the label. If you give medicine to your baby, follow your doctor’s advice about what amount to give. Do not give aspirin to anyone younger than 18. Aspirin has been linked to Reye syndrome, a serious illness.
- Put a warm cloth on the ear.
- Help your child rest by arranging quiet play.
- Give your child eardrops for pain if your doctor prescribes them.
Doctors may prescribe antibiotics if a child:footnote 1
- Is very ill from the infection. For example, your child may be dehydrated.
- Has other health problems, such as cleft palate or repeat infections that could put him or her at risk for serious problems from an ear infection.
- Has cochlear implants. Children who have these hearing devices are at risk for more serious infection.
Symptoms Of Ear Infections
- The main symptom is an earache.
- Younger children will cry, act fussy or have trouble sleeping because of pain.
- About 50% of children with an ear infection will have a fever.
- Complication: In 5% to 10% of children, the eardrum will develop a small tear. This is from the pressure in the middle ear. The ear then drains cloudy fluid or pus. This small hole most often heals over in 2 or 3 days.
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Can Ear Infections Be Prevented
Currently, the best way to prevent ear infections is to reduce the risk factors associated with them. Here are some things you might want to do to lower your childs risk for ear infections.
- Vaccinate your child against the flu. Make sure your child gets the influenza, or flu, vaccine every year.
- It is recommended that you vaccinate your child with the 13-valent pneumococcal conjugate vaccine . The PCV13 protects against more types of infection-causing bacteria than the previous vaccine, the PCV7. If your child already has begun PCV7 vaccination, consult your physician about how to transition to PCV13. The Centers for Disease Control and Prevention recommends that children under age 2 be vaccinated, starting at 2 months of age. Studies have shown that vaccinated children get far fewer ear infections than children who arent vaccinated. The vaccine is strongly recommended for children in daycare.
- Wash hands frequently. Washing hands prevents the spread of germs and can help keep your child from catching a cold or the flu.
- Avoid exposing your baby to cigarette smoke. Studies have shown that babies who are around smokers have more ear infections.
- Never put your baby down for a nap, or for the night, with a bottle.
- Dont allow sick children to spend time together. As much as possible, limit your childs exposure to other children when your child or your childs playmates are sick.
Causes Of A Middle Ear Infection
Middle ear infections are caused by viruses and bacteria, often resulting from other conditions that can cause blockage and swelling of the eustachian tubes that connect the throat and the middle ear. When this happens, a vacuum is created, allowing germs and fluid from the throat to enter the middle ear. A middle ear infection develops when bacteria or viruses grow in this fluid.
Children are more susceptible to middle ear infections than adults, partly because their eustachian tubes are narrower, so they are more easily blocked. Children also have relatively larger adenoids than adults. These are masses of tissue situated at the point where the nose bends into the throat that are vulnerable to infection, swelling and inflammation Ã¢â¬â when this happens, they can block the eustachian tubes and cause a middle ear infection.
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When Should I Call The Doctor
Very rarely, ear infections that don’t go away or severe repeated middle ear infections can lead to complications. So kids with an earache or a sense of fullness in the ear, especially when combined with fever, should be seen by their doctors if they aren’t getting better after a couple of days.
In Some Cases: Surgery
Ear infections often go away with time or with the help of antibiotics. However, some people may experience recurrent ear infections and fluid buildup, or have ear infections that wont heal for months.
In children, these issues can lead to hearing loss, behavioral issues, and speech development delays.
In these instances, a surgery called a tympanoplasty may help. In this procedure, a doctor inserts tiny tubes, called tympanostomy tubes or grommets, into the eardrum. These tubes reduce the occurrence of ear infections and allow drainage of excess fluids.
The procedure is very common and poses minimal risks. An ear tube insertion is more common for children, who tend to suffer ear infections more often than adults.
Home treatments for ear infections may be considered for mild cases in adults only.
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How Does A Doctor Diagnose A Middle Ear Infection
The first thing a doctor will do is ask you about your childs health. Has your child had a head cold or sore throat recently? Is he having trouble sleeping? Is she pulling at her ears? If an ear infection seems likely, the simplest way for a doctor to tell is to use a lighted instrument, called an otoscope, to look at the eardrum. A red, bulging eardrum indicates an infection.
A doctor also may use a pneumatic otoscope, which blows a puff of air into the ear canal, to check for fluid behind the eardrum. A normal eardrum will move back and forth more easily than an eardrum with fluid behind it.
Tympanometry, which uses sound tones and air pressure, is a diagnostic test a doctor might use if the diagnosis still isnt clear. A tympanometer is a small, soft plug that contains a tiny microphone and speaker as well as a device that varies air pressure in the ear. It measures how flexible the eardrum is at different pressures.
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