Watchful Waiting: Who Would Do It
Is watchful waiting ready for U.S. prime time? Harvard researcher Jonathan Finkelstein, MD, MPH, and colleagues note that some experts dont think its a good idea, despite the new treatment guidelines.
To see whether watching and waiting might really work for U.S. kids with otitis media, Finkelsteins team asked more than 2,000 parents and 160 doctors what they thought about holding off antibiotic treatment. Their findings:
- 38% of parents say theyd be satisfied or extremely satisfied with watchful waiting.
- 40% of parents say theyd be unsatisfied or extremely unsatisfied with watchful waiting.
- 38% of doctors say they never or almost never try watchful waiting.
- 39% of doctors say they occasionally try watchful waiting.
- 17% of doctors say they sometimes try watchful waiting.
- 6% of doctors say they recommend watchful waiting most of the time.
For parents, the results are clear.
Parental opinions in a community are likely to change as experience with successful treatment of acute otitis media without antibiotics becomes more common, Finkelstein and colleagues write.
For doctors, its not so clear. While there are community-wide benefits such as a reduction in antibiotic resistance, watchful waiting isnt a very great benefit to an individual patient. Some experts dont think its a good idea at all. And U.S. doctors tend to prefer active treatment over passive waiting.
How Do I Know If My Child Has An Ear Infection
Its important to visit a doctor to first determine what is wrong with your childs ear. First, they might just have an earache, not an ear infection. Earaches can be caused by anything from a cold to teething pain. If its an earache, a doctor will determine the cause before deciding on any treatment option.
Living With An Ear Infection
If your child suffers from several ear infections each year, youll want to look out for symptoms every time they have a stuffy nose or congestion.
Never stick anything in your childs ear to relieve the pain of an ear infection, to remove the tubes or remove a foreign object. See your childs doctor to have it removed.
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Symptoms Of Inner Ear Infection
Since the inner ear plays key roles in both hearing and balance, any issues with these senses could be linked to an infection in this area. Infections in other parts of the ear are less likely to affect your hearing or balance, but the other symptoms can be similar.
Possible signs of an inner ear infection or inflammation include:
- Vertigo, a sensation that you or your surroundings are spinning or moving around even when everything is still
- Having trouble balancing or walking normally
- Dizziness
- Feeling like the ear is full or blocked
- Tinnitus or ringing in your ears
- Earache
- Headaches
- Fluid or pus coming from your ear
Inner ear infections can also be linked to other symptoms, depending on the source of the infection. For example, if the infection spread to the inner ear from your airways, you might also have a runny nose. In some cases, these other symptoms might be fading when the problems in your inner ear begin, because the original infection might have been eliminated. You could also have more generalised symptoms of infection, such as a fever.
Symptoms Of Ear Infections
Intense pain in your childs ear is usually the first sign of an ear infection. Young children can tell you that their ear hurts, but babies may only cry. Your child may repeatedly pull on the ear that hurts. The pain is usually worse at night and when your child is chewing, sucking a bottle, or lying down. Thats when the pressure is at its greatest. Other symptoms include a runny nose, cough, fever, vomiting, or dizziness, and hearing loss.
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What Increases Your Risk
Some things that increase the risk for middle ear infection are out of your control. These include:
- Age. Children ages 3 years and younger are most likely to get ear infections. Also, young children get more colds and other upper respiratory infections. Most children have at least one ear infection before they are 7 years old.
- Birth defects or other medical conditions. Babies with cleft palate or Down syndrome are more likely to get ear infections.
- Weakened immune system. Children with severely impaired immune systems have more ear infections than healthy children.
- Family history. Children are more likely to have repeat middle ear infections if a parent or sibling had repeat ear infections.
- Allergies. Allergies cause long-term stuffiness in the nose that can block one or both eustachian tubes, which connect the back of the nose and throat with the middle ears. This blockage can cause fluid to build up in the middle ear.
Other things that increase the risk for ear infection include:
Things that increase the risk for repeated ear infections also include:
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How Long Does It Take To Recover From Yeast Infection
How long does a yeast infection last? Without treatment, it takes 3â7 days to recover from a yeast infection. It can take 1â2 weeks to recover from a moderate to severe yeast infection.
If you are experiencing symptoms of a yeast infection, it is important to seek medical treatment for the following reasons:
- It may not be what you think â Yeast infection symptoms are similar to those of other genital infections and sexually transmitted infections. Before you choose not to treat the problem, you need to know exactly what the problem is.
- It could get worse â Even if your symptoms start out mild, choosing not to treat them could make the infection worse. If the cause of your yeast infection is environmental or because of a lifestyle habit, not treating yourself could make your body more vulnerable to other infections.
- It could infect your partner â Choosing to opt out of treatment when you have a sexual partner can cause problems for the both of you. Yeast infections can be transmitted back and forth through genital contact. Without treatment and with continued sexual contact, your partner may develop a yeast infection. The infection may continue to be transmitted until one of you seeks treatment.
In mild cases of yeast infection, the problem may go away by itself. However, without knowing the cause of your yeast infection, choosing not to treat your infection may make it worse.
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How Is It Treated
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 childs 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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How To Get Rid Of Ear Infections Without Antibiotics Tips That Will Help You Eliminate Your Infection Fast
When you first notice an ear infection, you may think that it is the sign of a more serious problem. This can lead you to avoid the area or to try and treat it with over-the-counter drugs. However, your condition may be so minor that antibiotics just arent the right approach to take.
Antibiotics kill all bacteria in the body. But they dont always do a good job in getting rid of the underlying cause of the problem. Antibiotics kill off everything that might be able to live in the ear, including bacteria that cause ear infections. And, antibiotics only work in the short term and can actually create more of the problem in the long run.
- One example of an antibiotic that is used to get rid of an ear infection is the use of tetracycline to treat bacterial vaginosis. If the infection is caused by a buildup of harmful bacteria, tetracycline will kill it and keep it from growing back. Unfortunately, the growth of the bacteria usually leads to more problems as well.
- One of the reasons why antibiotics arent a good option for your ear is that they will likely kill off healthy earwax and other helpful bacteria. If the antibiotics are not taken on a regular basis, the bad bacteria will soon begin to outnumber the good.
Because of this, many people find that their ear infections continue to come back, sometimes even after they stop taking the antibiotics.
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Can An Ear Infection Be Prevented Or Avoided
Although an ear infection is not contagious, the bacteria or virus that caused it is often contagious. Its important to:
- Vaccinate your child with a pneumococcal conjugate vaccine to protect against several types of pneumococcal bacteria. This type of bacteria is the most common cause of ear infections. Get your childs vaccinations on time.
- Practice routine hand washing and avoid sharing food and drinks, especially if your child is exposed to large groups of kids in day care or school settings.
- Avoid second-hand smoke.
- Breastfeed your baby exclusively for the first 6 months and continue breastfeeding for at least 1 year. Place your baby at an angle while feeding.
Common allergy and cold medicines do not protect against ear infections.
Can Covid Cause Ear Infections
Ear infections have not been found to be a common symptom of COVID-19. However, more research is showing how COVID-19 can affect the human ear.
Hearing impairment and symptoms like severe gastric upsets and blood clots that result in gangrene are among some of the more serious symptoms being reported in some people who contracted the Delta variant of COVID-19 in India.
Some research has also pointed to COVID-19 being detected in the middle ear. A July 2020 study found that the autopsies of two people who died with COVID-19 tested positive for the virus in the middle ear.
The authors of the study wrote that this does not necessarily imply current or future otologic symptomatology in people who have COVID-19 infection present in their middle ear. More research needs to be done to better understand the effects of COVID-19 in the human ear.
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How Do Vets Diagnose Ear Infections In Dogs
Veterinarians diagnose ear infections in dogs based on clinical signs and diagnostic tests. Upon examination, your veterinarian will take a look at your dogs ear. They will most likely use a tool called an otoscope, which allows them to see into the ear canal and look for changes and signs of damage to the eardrum.
Seattle Children’s Urgent Care Locations
If your childs illness or injury is life-threatening, call 911.
Treatment for an Ear Infection
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When Else Are Antibiotics Needed
Antibiotics can be the right treatment for kids who get a lot of ear infections. Their doctors might prescribe daily antibiotics to help prevent future infections. And younger children or those with more severe illness may need antibiotics right from the start.
The “wait-and-see” approach also might not apply to children with other concerns, such as cleft palate, genetic conditions such as Down syndrome, or other illnesses such as immune system disorders.
How Long Do Ear Infections Last
Severe symptoms usually last for less then one to two days. If such symptoms last longer than one to two days, then it is important to consult with a doctor.
If symptoms do not go away and are left untreated, they can lead to complications and in rare cases more serious health issues
After an ear infection clears up, fluid may remain in the middle ear and cause some of the more mild symptoms and can persist for several weeks to months. This condition is diagnosed as otitis media with effusion.
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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.
Five Tips To Help Relieve Ear Infection Symptoms At Home
If your little one is cranky, unusually fussy and tugging at his or her ear or is feverish and having difficulty sleeping, chances are it may be due to an ear infection.
Five out of six children experience an ear infection by the time they are 3 years old, according to the National Institutes of Health. The odds are that your child will have an ear infection before kindergarten.
What causes an ear infection?
Ear infections can be caused by either bacteria or a virus, often following a cold. The common cold can cause the middle ear to become inflamed and fluid to build up behind the eardrum. The Eustachian tube, which connects the ears, nose and throat, can also become swollen.
Children are more susceptible to ear infections than adults because they have shorter and narrower Eustachian tubes, and it is easier for germs to reach the middle ear and for fluid to get trapped there, says Kara Hutton, MD, a pediatrician at Scripps Clinic Rancho Bernardo. Babies and children also have weaker immune systems, so it is more difficult for their bodies to fight an infection.
The onset of ear infections is often on day three of a cold. Ear infections peak at age 6 months to 2 years, and are a common problem until age 8, according to the American Academy of Pediatrics.
What is the best treatment for ear infection?
Some ear infections require antibiotic treatment, but many can get better without this medicine.
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Otitis Media In Adults
Otitis media is another name for a middle ear infection. It means an infection behind your eardrum. This kind of ear infection can happen after any condition that keeps fluid from draining from the middle ear. These conditions include allergies, a cold, a sore throat, or a respiratory infection.
Middle ear infections are common in children, but they can also happen in adults. An ear infection in an adult may mean a more serious problem than in a child. So you may need additional tests. If you have an ear infection, you should see your healthcare provider for treatment. If they happen repeatedly, you should see an otolaryngologist or an otologist .
What are the types of middle ear infections?
Infections can affect the middle ear in several ways. They are:
Who is more likely to get a middle ear infection?
You are more likely to get an ear infection if you:
- Smoke or are around someone who smokes
- Have seasonal or year-round allergy symptoms
- Have a cold or other upper respiratory infection
What causes a middle ear infection?
The middle ear connects to the throat by a canal called the eustachian tube. This tube helps even out the pressure between the outer ear and the inner ear. A cold or allergy can irritate the tube or cause the area around it to swell. This can keep fluid from draining from the middle ear. The fluid builds up behind the eardrum. Bacteria and viruses can grow in this fluid. The bacteria and viruses cause the middle ear infection.