Otitis Media / Ear Infections

Ear infections (otitis media) are often caused by bacterial infection in the middle ear. The middle ear is the area behind the eardrum. It is connected to the back of the throat by a passageway called the eustachian tube.

Usually an ear infection is preceded by several days of nasal congestion, caused by a cold or allergy. When the nose is congested, often the eustachian tube is congested too. This permits bacteria to be trapped in the middle ear space along with mucus or "fluid." When these germs multiply in the middle ear, pressure and pain can be the first symptoms your child experiences. Sometimes there is fever and often a temporary loss of hearing. Infants and younger children may have other symptoms not always obviously related to the ear: cough, sore throat, vomiting, diarrhea, stomach ache, etc.

When your doctor diagnoses an ear infection, your child will be given a prescription for an antibiotic. The antibiotic should kill the bacteria but may not always completely clear the middle ear space of "fluid." After all the medication has been taken (it should last usually 10 days), your child should be re-checked. If infection or fluid persists, more antibiotics (often a different type) may be needed because we may be dealing with a resistant germ. It is very important to have the ears rechecked because symptoms of persistent ear infection or "fluid" may not be obvious and may lead to hearing loss or difficulties with language or schooL Your child's doctor will advise you when to schedule your recheck appointment (usually two to four weeks).

Prevention (prophylaxis)
Sometimes the infection will be gone but persistent "fluid" in the middle ear may cause your child to be prone to recurrent episodes of infection or hearing loss. In this situation, long term use of antibiotics when your child appears to be well may be prescribed to reduce reinfection. It is important to continue this treatment as directed (usually one to four months), and to have the ear checked at the appropriate time specified by your doctor to see if the "fluid" has cleared up. If this fails to prevent recurrent episodes of ear infection, consultation with a specialist may be needed. 

All in all, having an ear infection may be an uncomfortable experience for many children. However, it is not life threatening nor an immediately dangerous condition. When your child has an earache at night or on the weekend, there are many things you can do to relieve pain until you can call for an appointment Acetaminophen is an excellent pain reliever and may be used to make the child more comfortable. Sometimes the use of a heating pad or hot water bottle for the child to put his ear against may relieve the discomfort as well. There are prescription ear drops which can be used to ease ear pain, but these drops must NOT be used if your child has tympanostomy (eardrum) tubes or a perforated (ruptured or draining) eardrum. Occasional use of medicines with codeine by mouth can also relieve pain. If your child has an earache, please try any of these measures to make your child comfortable until you can call the office in the morning for an appointment. It seems that many times earaches begin during the middle of the night. After hours emergency room visits may not be covered by some insurance or managed care health plans. We would like you to know that you can call our office at 8:00 a.m. to get an early morning appointment when your child has become ill during the night.

Ear Infections / Otitis Media

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