When Antibiotics Really Are Needed
According to the AAP guidelines, all babies under 6 months who develop an ear infection should be treated with antibiotics. Kids between 6 months and 2 years also should get antibiotics if their pediatrician is certain they have an ear infection. A child who has severe symptoms, such as extreme pain or a fever over 102.2 F, also should be treated with antibiotics even if the doctor isn’t 100 percent certain she has an ear infection.
Most children with certain chronic health issues also should be put on antibiotics for an ear infection. This includes kids with Down syndrome, immune system problems, cleft palate, or a cochlear implant. The same holds true for any child who’s had an ear infection in the previous 30 days or has chronic fluid in her ears.
Ear Infection Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
How Do Ear Infection Antibiotics Work
Ear infections are no fun for anyone.
An ear infection occurs when fluid builds up behind your eardrum in the middle part of your ear and causes swelling . This can lead to significant pain and discomfort.
Since most ear infections are caused by bacteria, its typically best to treat individual cases with antibiotics.
But antibiotic treatment isnt appropriate for every ear infection. There are a variety of factors to consider, including:
Recurring ear infections may also require a different approach.
If youre considering ear infection antibiotics for yourself or a loved one, learn more about how these medications work and how they can be both helpful and possibly harmful.
Ear infections are most prevalent in young children. Theyre often the byproducts of upper respiratory infections.
You or your child might experience other symptoms before the ear infection, including:
If an upper respiratory infection is caused by bacteria, then its possible to have an ear infection at the same time.
An ear infection occurs when bacteria gets trapped in your middle ear. Bacteria known as Hemophilus influenza and Streptococcus pneumoniae are the most common bacterial culprits.
But an ear infection may still occur if you have a viral respiratory illness. As you recover, its possible for bacteria to travel to your middle ear and become trapped, leading to a secondary infection in your ears.
Check If Its An Ear Infection
The symptoms of an ear infection usually start quickly and include:
- 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.
| Inner ear infection | ||
|---|---|---|
| Can affect both children and adults | Usually affects children | Usually affects adults aged 45 to 75 |
| Caused by viral or bacterial infections | Caused by viruses like colds and flu | Caused by something irritating the ear canal, such as eczema, water or wearing earplugs |
| Affects parts of the inner ear like the labyrinth and vestibular system, and can lead to labyrinthitis | Affects the eustachian tube, which connects the middle ear to the back of the nose | Affects the ear canal |
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Preventing Ear Infections In The First Place
The AAP also recommends taking measures to reduce risk factors for ear infections, especially during infancy. These include breastfeeding for at least six months, never giving a baby a bottle while she’s lying down, and weaning from a pacifier after six months. And kids of all ages should be kept away from second-hand smoke.
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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Response To Antibiotic Treatment
Your child’s symptoms, including fever, should improve within 48 to 72 hours after beginning antibiotics. If symptoms do not improve it may be because a virus is present or the bacteria causing the ear infection is resistant to the prescribed antibiotic. A different antibiotic may be needed.
In some children whose treatment is successful, fluid will still remain in the middle ear for weeks or months, even after the infection has resolved. During that period, children may have some hearing problems, but eventually the fluid almost always drains away.
If your child fails to improve and middle ear fluid remains, your doctor may recommend consultation with an ear, nose, and throat specialist . This specialist may perform a tympanocentesis procedure in which fluid is drawn from the ear and examined for specific bacterial organisms. But this is reserved for severe cases.
Check If It’s An Ear Infection
The symptoms of an ear infection usually start quickly and include:
- 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.
If you, or your child, have a high temperature or you do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better.
| Inner ear infection | Middle ear infection | Outer ear infection |
|---|---|---|
| Can affect both children and adults | Usually affects children | Usually affects adults aged 45 to 75 |
| Caused by viral or bacterial infections | Caused by viruses like colds and flu | Caused by something irritating the ear canal, such as eczema, water or wearing earplugs |
| Affects parts of the inner ear like the labyrinth and vestibular system, and can lead to labyrinthitis | Affects the eustachian tube, which connects the middle ear to the back of the nose | Affects the ear canal |
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What Are The Symptoms Of A Kidney Infection
Symptoms usually develop quickly, over a few hours or so, and may include:
- Pain in a loin or flank. .
- High temperature which may cause shivers.
- Feeling sick and/or being sick .
- Blood in the urine.
- There will also usually be symptoms of a bladder infection for example, pain on passing urine, and going to the toilet often.
Not all of the symptoms may develop, and sometimes a kidney infection can just cause vague symptoms. For example, just feeling generally unwell but not being able to say why.
In older people a kidney infection may cause confusion. This is why a urine test is often done when an elderly person suddenly becomes confused or appears generally unwell.
su91629
0 likes, 16 replies
Posted 4 years ago
I had one kick in hard after surgery and right after being on cipro for over a week. On top of bring on it a couple weeks before that. Resistant strain of infection. Cipro did nothing.
Posted 4 years ago
Did you find something that eventually worked? Right now Im waiting for a few days for the culture to come back. I dont know what antibiotic they will try this time.
Posted 4 years ago
It got out of control. Went staph. In hospital for 5 days in IV meds. One was venctomycin. Sent me home after that with bactrum.
Antibiotics Can Help In Some Children
Some children may benefit more from than others: These include children who are under two years old and have an infection in both ears, and those of all age groups who are leaking pus from their ear. Both symptoms are signs of a bacterial infection, which can be treated effectively with antibiotics.
After three to seven days, out of children under two years of age with acute middle ear infection in both ears
- 55 out of 100 children who did not take still had an earache or fever, and
- 30 out of 100 children who used still did.
So the worked in 25 out of 100 of these children.
They also helped children who had fluid leaking from their ears.
- 60 out of 100 children who did not take still had fever or an earache,
- but only 24 out of 100 who used did.
So helped in 36 out of 100 children who had fluid leaking from their ears.
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A Pharmacist Can Help With An Ear Infection
Speak to a pharmacist if you think you have an outer ear infection.
They can recommend acidic eardrops to help stop bacteria or fungus spreading.
- a long-term medical condition such as diabetes or a heart, lung, kidney or neurological disease
- a weakened immune system because of chemotherapy, for example
How Does It Cause Disease
As long as air entering from the back of the nose is able to reach the middle ear space via the eustachian tube, the middle ear rarely becomes infected. The eustachian tube in younger children is flimsy and easily collapses. As the child grows, the cartilage tissue surrounding the eustachian tube becomes stiffer, longer, and more angulated inside the skull.
Pneumococcus, Haemophilus, and Moraxella commonly reside in the back of the nose, and do not infect the child. Once a child becomes infected with a respiratory virus, it not only causes congestion of the nose and the lungs, but also of the eustachian tube. When this tube becomes clogged, the cells in the middle ear space produce a fluid-like substance, which allows bacteria to grow and infect the middle ear space. A virus infection precedes up to 90% of cases of acute otitis media.
Respiratory virus infections also trigger ear infections by upsetting the body’s normal defenses in the nose and the eustachian tube, and allowing certain normal bacteria that reside in the nose to “stick” better to the lining of the nose and the eustachian tube. Certain viruses, such as the flu and RSV , are more frequently associated with ear infections. Occasionally, the child’s nose becomes colonized by a new aggressive strain of bacteria, which rapidly invades the middle ear. Unfortunately, more exposures to viruses and new strains of bacteria increase the likelihood of ear infections.
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What If My Ear Infection Doesnt Go Away After Antibiotics
If you or your child finish your course of antibiotics, but it seems like the ear infection hasnt gone away, make an appointment with your doctor. Theyll help figure out whats going on and what to do next. Theres a chance that your doctor may prescribe a different type of antibiotic to see if it works better.
Its also possible that the infection is gone but the symptoms arent. This can happen if theres still fluid trapped in the ear, causing a plugged-up feeling, pain or hearing loss. Most of the time the fluid in ears drains within a couple of weeks, but sometimes it sticks around longer.
What Is Acute Otitis Media
Acute otitis media is an infection of the middle ear, generally caused by bacteria. In acute otitis media , pus and infected fluid accumulate in the middle ear space.
The tympanic membrane appears inflamed, reddened, and often protrudes outward. Usually, an ear infection begins after the eustachian tube has become swollen, congested, and closed, most commonly resulting from an ongoing viral respiratory infection.
Acute otitis media should not be confused with: 1) external otitis -a painful bacterial infection of the superficial skin of the ear canal, or 2) otitis media with effusion -an accumulation of non-inflamed fluid behind the eardrum. Otitis media with effusion is not considered infected, and most doctors do not treat it with antibiotics. This uninfected fluid in the middle ear is a remnant in 50% to 60% of resolved ear infections. It is frequently a mild complication of colds, respiratory illnesses, or nasal allergies.
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Whats The Difference Between Antibiotic Solutions And Suspensions
Solutions are liquids where the active ingredients are dissolved. Suspensions are liquids in which the particles are suspended, or scattered throughout the liquid, and not quite dissolved. Some medications are stable as a suspension but not as a solution.
The main difference between the two is how irritating they might be. Antibiotic solutions are generally more irritating than suspensions because solutions have a more acidic pH of 3-4, whereas suspensions have a less acidic pH of 5.
Solutions may also contain alcohol to help kill bacteria, but the alcohol can be extremely irritating when these solutions are applied.
Research May Reveal Why Some Ear Infections Refuse To Go Away
Unfortunately for kids with painful ear infections, whatever doesnt kill the bacteria invading their middle ears will only make them stronger.
New laboratory research suggests that antibiotics commonly used to treat ear infections can stimulate certain strains to form mats, called biofilms, which protect the bacteria from antibiotics. The results may explain why some earaches return, even after multiple rounds of antibiotics.
People come into contact with biofilms all the time. They are the gunk on your teeth after eating candy and the red scum on your unscrubbed tub. But when infectious bacteria form biofilms in the body, they can be especially hard to remove.
Biofilms help bacteria to evade antibiotics by shielding live cells with layers upon layers of dead bacterial cells, which are held together by sticky sugars, proteins, and even long strands of DNA released from the dead microbes. This glue-like mix of materials sticks the cells to one another and to surfaces in the body.
In the lab, the researchers exposed different strains of NTHi to three antibiotics commonly prescribed to treat ear infections. Though the bacteria can form biofilms on their own, when exposed to lower, sub-lethal levels of antibiotics, many made bigger, thicker films. This could happen in the body when a person misses a dose, stops treatment early or when inflammation prevents the drugs from reaching the ear fluid.
But many parents still want an immediate prescription, just to be safe.
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What Are The Harms Of Fluid Buildup In Your Ears Or Repeated Or Ongoing Ear Infections
Most ear infections dont cause long-term problems, but when they do happen, complications can include:
- Loss of hearing: Some mild, temporary hearing loss usually occurs during an ear infection. Ongoing infections, infections that repeatedly occur, damage to internal structures in the ear from a buildup of fluid can cause more significant hearing loss.
- Delayed speech and language development: Children need to hear to learn language and develop speech. Muffled hearing for any length of time or loss of hearing can significantly delay or hamper development.
- Tear in the eardrum: A tear can develop in the eardrum from pressure from the long-lasting presence of fluid in the middle ear. About 5% to 10% of children with an ear infection develop a small tear in their eardrum. If the tear doesnt heal on its own, surgery may be needed. If you have drainage/discharge from your ear, do not place anything into your ear canal. Doing so can be dangerous if there is an accident with the item touching the ear drum.
- Spread of the infection: Infection that doesnt go away on its own, is untreated or is not fully resolved with treatment may spread beyond the ear. Infection can damage the nearby mastoid bone . On rare occasions, infection can spread to the membranes surrounding the brain and spinal cord and cause meningitis.
How Do You Know When Your Child Has An Ear Infection
The most common symptom of an ear infection is ear pain. While an older child can tell you that his ear hurts, a younger child may simply act irritable and cry more than usual. Lying down, feeding, and sucking cause painful pressure changes in the middle ear, so the child may eat less than the normal amount or have trouble sleeping. Other symptoms are fever, loss of balance, difficulty hearing, and yellow or blood-spotted drainage from the child’s ear. If your child tugs at her ear, it may not be due to an ear infection. Ear pain or irritability can also be caused by a sore throat, teething, or swimmer’s ear.
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What Is The Treatment For Ear Infections
Medications used to treat ear infections include:
- Pseudoephedrine to ease ear pressure
- Antibiotic ear drops for infections of the ear canal
- Oral antibiotics for infections of the middle ear , and severe infections of the outer ear
For mild cases of ear infection, doctors often recommend watching and waiting before starting use of antibiotics, as many cases will go away on their own. Consult your childs pediatrician before giving any over-the-counter medications to your child.
Home remedies to relieve symptoms include:
- Warm compresses applied to the area to help soothe pain
- Over-the-counter pain eardrops