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 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.
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
Accidentally Taking An Extra Dose
There’s an increased risk of side effects if you take 2 doses closer together than recommended.
Accidentally taking 1 extra dose of your antibiotic is unlikely to cause you any serious harm.
But it will increase your chances of getting side effects, such as pain in your stomach, diarrhoea, and feeling or being sick.
If you accidentally take more than 1 extra dose of your antibiotic, are worried or you get severe side effects, speak to your GP or call NHS 111 as soon as possible.
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When To Call The Doctor For An Ear Infection
Some symptoms of an inner ear infection can be the same as a stroke. If you have vomiting, headache, vision changes, fever, weakness in one side of your body, slurred speech or are unable to walk, seek medical care right away.
Infections involving high fever, discharge or bleeding from the ear canal, headache, vomiting, dizziness, loss of hearing, or severe pain should be seen by a doctor. A doctor should see most people with an inner ear infection.
Before Taking This Medicine
Do not use this medication if you are allergic to penicillin V or to any other penicillin antibiotic, such as:
Before using penicillin V, tell your doctor if you are allergic to any drugs , or if you have:
a bleeding or blood clotting disorder
a history of diarrhea caused by taking antibiotics or
a history of any type of allergy.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take penicillin V.
FDA pregnancy category B. Penicillin V is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Penicillin V can make birth control pills less effective, which may result in pregnancy. Before taking this medicine, tell your doctor if you use birth control pills. Penicillin V can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
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What If I Forget To Take It
If you forget to take a dose, take it as soon as you remember, unless it’s nearly time for your next dose.
In this case, just leave out the missed dose and take your next dose as normal.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicines.
Diagnosis Of Ear Infections
Your physician will look into your ear with an otoscope, a medical instrument with a light on one end designed to get a better view inside the ear. Your doctor will look for the visual signs of ear infection, such as redness and inflammation.
To check for fluid buildup, a pneumatic otoscope, which blows air at the eardrum, will be used. If there is excessive fluid behind the eardrum, it will not move as it should when the air hits it.
In some cases, hearing tests may also be performed to assess any damage to the ear from the infection.
Different types of ear infections present with different symptoms, which can include:
- Inner ear infections: Hearing loss, ringing in the ears , dizziness, loss of balance, nausea and vomiting, and ear pain
- Middle ear infections: Fluid in the ear, ear pain, fever, a feeling of general illness, pressure in the ears, and hearing loss
- Outer ear infections: Inflammation of the ear canal, itching in the ear, ear pain, swelling of the ear canal, redness, and fluid draining from the ear
Ear Infection Doctor Discussion Guide
Children with ear infections, especially toddlers or infants, may not be able to describe their symptoms, but an ear infection will often present with the following signs:
- Tugging or pulling at their ears
- Fussing or crying
- Being clumsy and having balance issues
- Trouble hearing or responding to quiet noises
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Combatting The Myth Of Amoxicillin Immunity
A major complication of amoxicillin failure is that it convinces many parents that “amoxicillin doesn’t work for my child anymore.” Once a patient has failed to respond to amoxicillin therapy, it is tempting to label that patient “amoxicillin unresponsive” and to exclude amoxicillin from the armamentarium available for future episodes of AOM. However, as reviewed above, it is inappropriate to attribute all episodes of amoxicillin-unresponsive AOM to resistance. In most cases, the bacteria isolated from these patients are sensitive to amoxicillin. The impact of initial antibiotic choice on outcome is minimal. One population-based study found a 12% to 13% rate of antibiotic failure as measured by a prescription for a second course of antibiotics within three weeks.35 The failure rate was similar regardless of the agent first prescribed, but the cost of the prescription was five- to 20-fold higher for the second-line agent. So, despite occasional failure, amoxicillin should remain the first choice for pediatric patients with AOM.
Patients with recurrent AOM might benefit from influenza and pneumococcal immunization, and their parents may respond to a discussion of risk factors such as cigarette smoke, pacifiers, and group day care. Most parents are more willing to accept a watchful approach to AOM therapy once they understand the risks that “antibiotic roulette” poses to a child in day care.
When Antibiotics Are Used
Antibiotics are typically only prescribed for AOM.
OME and COME occur after an infection has already occurred. Antibiotics cant treat fluid buildup if theres no active infection.
An antibiotic may be prescribed for an active ear infection once your doctor has examined your ear and has determined you exhibit signs and symptoms of AOM or swimmers ear.
Frequent or recurring ear infections should also be addressed with a doctor. Due to concerns with antibiotic resistance, recurring ear infections or COME shouldnt always be treated with antibiotics.
Depending on the severity of your ear infection, your doctor may hold off on prescribing antibiotics.
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Check If It’s An Ear Infection
The symptoms of an ear infection usually start quickly and include:
- pain inside the ear
- a high temperature of 38 degrees Celsius or above
- being sick
- discharge running out of the ear
- a feeling of pressure or fullness inside the ear
- itching and irritation in and around the ear
- scaly skin in and around the ear
Young children and babies with an ear infection may also:
- rub or pull their ear
- not react to some sounds
- be irritable or restless
- be off their food
- keep losing their balance
Most ear infections clear up within 3 days, although sometimes symptoms can last up to a week.
How To Treat An Ear Infection At Home
Which parts of the ear can become infected?
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When You Need Themand When You Dont
Many children get ear infections. The infections are usually in the middle ear behind the eardrum. They may be caused by bacteria or by a virus. Doctors often treat bacterial infections with antibiotics. Antibiotics are strong medicines that kill bacteria.
Infants and some babies and children do need antibiotics.
But using antibiotics too often can be harmful. Heres why:
In most cases, antibiotics are not needed.
- They do not work for ear infections caused by viruses.
- They do not help the pain.
- Usually, viral infections and many bacterial infections go away on their own in two to three days, especially in children who are over two years old.
First, call the doctor and treat the pain.
If you suspect your child has an ear infection, you should call the doctors office and describe the symptoms. Usually, your doctor should ask you to wait a few days before bringing your child in.
The main sign of an ear infection is pain, especially on the first day. Or, a child may have a fever.
Start by giving your child an over-the-counter pain reliever, such as:
- acetaminophen .
- ibuprofen .
Antibiotics do not relieve pain in the first 24 hours. They only have a small effect on pain after that. So, pain relievers are an important treatment, and usually they are the only treatment needed.
When is treatment with antibiotics needed?If the infection is very painful and lasts more than a few days, chances are it is a bacterial infection.
What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room temperature and away from excess heat and moisture . Keep the oral solution in the refrigerator, tightly closed, and dispose of any unused medication after 14 days. Do not freeze it.
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
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The Natural History Of Aom
Surprisingly, clinical outcome of antibiotic therapy for AOM correlates poorly with in vitro antibiotic sensitivity of the causative organism. Most experimental evidence demonstrates that clinical outcome is determined chiefly by host and pathogen factors and that antibiotic therapy plays a smaller role. In general, antibiotic therapy has little effect on long-term outcome of AOM, such as clearance of effusion. The high rate of spontaneous resolution and the frequent occurrence of recalcitrant AOM have made it almost impossible to demonstrate any significant difference between different antibiotic therapies in clinical trials.
Chlamydia pneumoniae is an atypical pathogen commonly associated with upper respiratory infections in children. It differs from the otitis pathogens just described in that it is relatively insensitive to b-lactams but, for now at least, remains sensitive to macrolides. In fact, C pneumoniae has been recently detected by culture or polymerase chain reaction in up to 8% of middle ear specimens.19 However, it is also commonly found in nasopharyngeal specimens from well preschoolers.20 In the few cases of C pneumoniae associated AOM studied, most infected patients improved without macrolide therapy. Clearly, this area needs further study. For now, we do not believe that the theoretical benefit of action against atypical organisms justifies the use of macrolide antibiotics as routine second-line therapy for amoxicillin-unresponsive AOM.
What Is The Dosage Of Amoxicillin Vs Penicillin
- For most infections in adults the dose of amoxicillin is 250 mg every 8 hours, 500 mg every 8 hours, 500 mg every 12 hours or 875 mg every 12 hours, depending on the type and severity of infection.
- For the treatment of adults with gonorrhea, the dose is 3 g given as one dose.
- For most infections, children older than 3 months but less than 40 kg are treated with 25 or 45 mg/kg/day in divided doses every 12 hours or 20 or 40 mg/kg/day with one-third of the daily dose given every 8 hours depending on the type and severity of the infection.
- Amoxicillin can be taken with or without food.
Penicillin antibiotics are available as
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Types Of Ear Infections
The most common type of ear infection is called acute otitis media .
AOM is more common in children because they have smaller eustachian tubes. Located between the middle ear and upper throat, these tubes are responsible for fluid drainage.
If this fluid doesnt drain, a buildup and infection may occur. Fluid trapped in the middle ear behind your eardrum may also cause:
Other common infections
Other common types of ear infections include:
- Otitis media with effusion . The infection has cleared up, but fluid may still be stuck in the middle ear.
- Chronic otitis media with effusion . Fluid continues to build up on a recurring basis despite the lack of infection. This chronic condition can lead to serious side effects, such as hearing loss .
- Swimmers ear : occurs in the outer ear when water becomes trapped and promotes bacterial growth in the ear canal.
How Is An Ear Infection Diagnosed
Patients who experience ear infections should seek medical attention if they are concerned with the severity or type of ear infection. Ear infections are common and can often be caused by many different factors.
A viral infection is the most common cause of an inner ear infection whereas outer ear infections are usually caused by bacteria. Middle ear infections can be a result of bacterial infections, a virus, or other illness like a cold, flu, or allergies.
Fortunately, there are steps that you can take to prevent ear infections. earplugs if swimming in freshwater, do not use q tips, hairpins, or other sharp objects in the ear canal, keep use decongestant when congested from cold, says Inna Husain, MD, an otolaryngologist and assistant professor at Rush University Medical Center in Chicago.
Ear infections are diagnosed by performing a physical examination. A primary healthcare professional, family physician, or ear, nose, and throat doctor may inspect the ears for infection using a tool such as an otoscope, which blows a puff of air into the ear. If the eardrum doesnt move, the patient could have fluid buildup. Depending on the type of ear infection, the doctor may also check for symptoms of an ear infection such as a fever or drainage of the ear. The healthcare professional may also ask questions about certain risk factors pertaining to ear infections, which might include:
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Side Effects Of Antibiotics
As with any medicine, antibiotics can cause side effects. Most antibiotics do not cause problems if they’re used properly and serious side effects are rare.
The common side effects include:
- being sick
- bloating and indigestion
Some people may have an allergic reaction to antibiotics, especially penicillin and a type called cephalosporins. In very rare cases, this can lead to a serious allergic reaction , which is a medical emergency.
Read more about the side effects of antibiotics.