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About Middle Ear Infections

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Otitis media is an infection of the middle ear that causes inflammation and a build-up of fluid behind the eardrum.

Anyone can develop a middle ear infection but infants between six and 15 months old are most commonly affected.

It’s estimated that around one in every four children experience at least one middle ear infection by the time they’re 10 years old.

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Resources:

1) Johns Hopkins Antibiotic Guide

2) Lexicomp

3) Ear Infection, Centers for Disease Control and Prevention, 5 May 2021,

4) Swimming and Ear Infections,Centers for Disease Control and Prevention, 5 May 2021,

How Is An Acute Middle Ear Infection Treated

Many doctors will prescribe an antibiotic, such as amoxicillin, to be taken over seven to 10 days. Your doctor also may recommend over-the-counter pain relievers such as acetaminophen or ibuprofen, or eardrops, to help with fever and pain.

If your doctor isnt able to make a definite diagnosis of OM and your child doesnt have severe ear pain or a fever, your doctor might ask you to wait a day or two to see if the earache goes away. The American Academy of Pediatrics issued guidelines in 2013 that encourage doctors to observe and closely follow these children with ear infections that cant be definitively diagnosed, especially those between the ages of 6 months to 2 years. If theres no improvement within 48 to 72 hours from when symptoms began, the guidelines recommend doctors start antibiotic therapy. Sometimes ear pain isnt caused by infection, and some ear infections may get better without antibiotics. Using antibiotics cautiously and with good reason helps prevent the development of bacteria that become resistant to antibiotics.

If your doctor prescribes an antibiotic, its important to make sure your child takes it exactly as prescribed and for the full amount of time. Even though your child may seem better in a few days, the infection still hasnt completely cleared from the ear. Stopping the medicine too soon could allow the infection to come back. Its also important to return for your childs follow-up visit, so that the doctor can check if the infection is gone.

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What Are Symptoms Of An Ear Infection

Ear infections most often occur in the middle part of the ear. Ear infections in children commonly include the following symptoms:

  • Pulling at one or both ears

  • Crying

  • solution

Your doctor will assess the type of bacteria likely causing your ear infection to determine which antibiotic to give you. Most people begin feeling relief within 24 hours of starting a course of antibiotics, and symptoms should improve significantly within 48-72 hours.

How Is It Treated

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Most ear infections go away on their own, although antibiotics are recommended for children younger than 6 months of age and for children at high risk for complications. You can treat your child at home with an over-the-counter pain reliever like acetaminophen , a warm cloth on the ear, and rest. Do not give aspirin to anyone younger than 18. Your doctor may give you eardrops that can help your child’s pain. Be safe with medicines. Read and follow all instructions on the label.

Your doctor can give your child antibiotics, but ear infections often get better without them. Talk about this with your doctor. Whether you use them will depend on how old your child is and how bad the infection is.

Minor surgery to put tubes in the ears may help if your child has hearing problems or repeat infections.

Sometimes after an infection, a child cannot hear well for a while. Call your doctor if this lasts for 3 to 4 months. Children need to be able to hear in order to learn how to talk.

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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.

What Are The Signs And Symptoms Of An Inner Ear Infection

Ear infections can happen anywhere in your outer, middle or inner ear. The symptoms can be very different depending on where the problem is located. If the infection is in your inner ear then it can have a particularly dramatic effect on your senses of balance and hearing. Read on to learn more about inner ear infections and how they can affect you.

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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.

When Should You Call Your Doctor

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  • Your child has sudden hearing loss, severe pain, or dizziness.
  • Your child seems to be very sick with symptoms such as a high fever and stiff neck.
  • You notice redness, swelling, or pain behind or around your child’s ear, especially if your child doesn’t move the muscles on that side of his or her face.
  • You can’t quiet your child who has a severe earache by using home treatment over several hours.
  • Your baby pulls or rubs his or her ear and appears to be in pain .
  • Your child’s ear pain increases even with treatment.
  • Your child has a fever of 38.3°C or higher with other signs of ear infection.
  • You suspect that your child’s eardrum has burst, or fluid that looks like pus or blood is draining from the ear.
  • Your child has an object stuck in his or her ear.
  • Your child with an ear infection continues to have symptoms after 48 hours of treatment with an antibiotic.
  • Your child with an ear tube develops an earache or has drainage from his or her ear.

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Best Way To Treat An Ear Infection

An ear infection can be a common occurrence, particularly in children. It can cause pain, a fever, and hearing loss, and although ear infections often go away on their own, treatment may be required to reduce painful symptoms or prevent reoccurring infections.

Where Can I Find Additional Information About Ear Infections

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language.

Use the following keywords to help you search for organizations that can answer questions and provide printed or electronic information on ear infections:

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Can You Take Amoxicillin For An Ear Infection

ear infectionsear infection canamoxicillinear infectionswill10.Perform the Valsalva maneuver

  • Close your mouth and gently squeeze your nostrils shut with your fingers.
  • Breathe deeply, and slowly blow the air out of your nose. If you hear a popping sound, it means the eustachian tubes have opened.
  • Tilt your head to allow the water to drain from your ear.
  • Oral Antibiotics Have Risks

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    • Oral antibiotics are more likely to cause resistant bacteria outside the ear. When that happens, these medicines will not work as well in the future. Illnesses will be harder to cure and more costly to treat.
    • Antibiotic eardrops kill the bacteria faster and more completely than oral antibiotics. Drops dont go into the bloodstream, so more medicine reaches the infection.

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    How To Treat An Ear Infection At Home

    Ear infections can be caused by viruses, bacteria, or rarely yeast. There are three areas in the ear where ear infections can occur in adults and children.

  • Outer ear infections : An outer ear infection most commonly experienced is often known as swimmers ear. This infection usually is due to bacterial infection of the skin tissue covering the ear canal. Excessive immersion in water or injuring the ear canal by putting things in it makes you more likely to develop an outer ear infection.
  • Middle ear infections: A middle ear infection is an infection just behind the eardrum with pus trapped in the adjacent hollow cavity of the facial bone. Middle ear infections frequently are a complication of the common cold in children. Most middle ear infections are caused by viruses and will resolve spontaneously. Bacterial infections cause some middle ear infections, which requires antibiotic treatment.
  • Inner ear infections: Inner ear infections are very rare, and usually are caused by a virus. These infections are more accurately characterized as inflammation of the structures of the inner ear . Since these structures affect hearing and balance, inner ear infections cause symptoms such as ringing of the ears or dizziness and balance disruption . Usually, inner ear infections in adults and children need medical treatment.
  • Which parts of the ear can become infected?

  • The outer earincludes the cartilaginous structure and ear canal ending at the eardrum .
  • The Best Medicine For An Ear Infection

    When trying to combat an ear infection, there are different avenues you can take in terms of relieving the pain and eradicating the infection. For example, pain relievers, such as Tylenol and Motrin, are used in relieving pain or discomfort associated with an ear infection. On the other hand, though, antibiotics like amoxicillin or ofloxacin .3% ear drops, are important for fighting off the bacteria that triggered the condition.

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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.

    What’s Best For Recurrent Ear Infections In Kids

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    HealthDay Reporter

    THURSDAY, May 13, 2021 — Frequent middle-ear infections are the nemesis of many parents and young children. Now a new study suggests that a common treatment — “ear tubes” — may not prevent future bouts.

    Middle-ear infections are second only to the common cold in creating childhood misery. They occur when the air-filled space behind the eardrum becomes infected and fills with fluid — which can cause pain, fever and obstructed hearing.

    Some babies and young children are prone to frequent infections. One treatment option is to surgically place a tiny tube in the eardrum, to help drain fluid built up behind it.

    But the new study, published May 13 in the New England Journal of Medicine, found that the tactic did not thwart future infections.

    Among 250 babies and toddlers researchers followed, those treated with ear tubes suffered about as many middle-ear infections over the next two years as those who received only antibiotics for each bout.

    The good news is that infections in both groups dissipated over time, said lead researcher Dr. Alejandro Hoberman of UPMC Children’s Hospital of Pittsburgh.

    Kids normally outgrow the infections, he explained. Babies and toddlers are prone to them because of the structure of their eustachian tubes, which help drain fluid from the middle ear. As little ones grow older, that changes.

    According to Hoberman, the new findings suggest that for many children, tubes can be avoided.

    Continued

    Continued

    More information

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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.
  • Swimmers Ear:otitis externa is an infection of the outer ear canal. This is different from a middle ear infection. It can happen after swimming or bathing.
  • Causes: Swimmers Ear usually occurs when water stays in the outer ear canal for too long, creating a moist environment ideal for bacteria growth.
  • Symptoms: Common symptoms of Swimmers Ear include redness and swelling in the ear, drainage from the ear, itchiness inside the ear, and pain when pressure is put on the outer ear or when it is tugged on.
  • What Does The Doctor Do

    The doctor will look into your ear with a special flashlight called an otoscope . With the otoscope, the doctor can see your eardrum, the thin membrane between your outer and middle ear.

    The doctor may use the otoscope to blow a little puff of air in your ear. Why? To see if the air causes your eardrum to move the way a healthy eardrum does. An infected eardrum won’t move as it should because the pus presses against it and may make it bulge. An infection also can make the eardrum red.

    If you have an ear infection, the doctor will make a decision about what to do next. He or she might ask your parent to watch you over the next day or two to see if you get any better. The doctor also might suggest a pain reliever to keep you comfortable.

    If bacteria are causing the problem, the doctor might prescribe a medicine called an antibiotic , which usually clears up a bacterial infection, so you’ll feel better in a few days.

    If you are given an antibiotic, it’s very important to keep taking the medicine for as many days as the doctor instructs even if your ear stops hurting. If you don’t take all the medicine, the infection could come back and your ear will start hurting again.

    A kid who has chronic, or frequent, ear infections might need a few other tests. They include an audiogram , which tests your hearing, and a tympanogram , a machine that checks whether your eardrum moves normally.

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    When To See A Doctor

    Ear infections can go away on their own in many cases, so a minor earache may not be a worry.

    A doctor should typically be seen if symptoms have not improved within 3 days. If new symptoms occur, such as a fever or loss of balance, a doctor should be seen immediately.

    Any sign of discharge coming from the ear would also require a visit to the doctor.

    What Are The Advantages Of Ototopical Antibiotics

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    Administration of antibiotics directly in the ear has several advantages over systemic delivery including the following:

    Antibiotic concentration

    Topical antibiotic solutions contain vastly greater concentration of antibiotic than the medications administered orally, or even intravenously. The high antibiotic concentration, delivered directly at the site of the infection, is much more effective in killing the bacteria. It also reduces the possibility for development of antibiotic-resistant bacterial strains.

    The lowest level of drug concentration that can prevent bacterial growth is known as minimum inhibitory concentration . Some drug-resistant bacteria have a high MIC, but ototopical antibiotics far exceed the MIC required for destroying even highly resistant bacteria.

    Absence of systemic effects

    The absence of systemic effects with topical administration eliminates the risk of systemic antibiotic side effects. The normal beneficial bacteria that live in the respiratory and gastrointestinal tracts are unaffected. Absence of systemic antibiotics also prevents the natural selection and proliferation of drug-resistant bacteria.

    Alteration of microenvironment

    Treatment cost

    Ototopical antibiotics are generally less expensive than comparable systemic medications.

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