Monday, January 30, 2023

Oral Antibiotics For Ear Infection

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What Does An Infected Ear Piercing Look Like 10 Photos To Help You Spot An Infection

Otitis media and Antibiotics

Plus, doctors explain what to do if you have one.

BY KORIN MILLER

In a perfect world, youd get your ears pierced and spend the rest of your life effortlessly rocking cute earrings. In reality? Sometimes piercings get infected, andnot gonna sugar-coat itit can be really effing gross.

Luckily, infected ear piercings arent the norm and, if you get pierced at a reputable place and practice solid piercing after-care, youre probably going to be just fine. Still, infected piercings can and do happen to good people. Whomp, whomp.

If you find your piercing looking or feeling a littleoff, it can be hard to tell the difference between minor irritation and a full-blown infection. But Kenneth A. Kaplan, MD, an otolaryngologist with ENT and Allergy Associates in New Jersey, and Leila Mankarious, MD, an ear, nose and throat specialist at Massachusetts Eye and Ear, are here to clear things up that confusion and answer all the burning questions you have about infected ear piercings.

Plus, the 10 photos ahead can help you identify if youre indeed dealing with an infection.

How do ear piercings even get infected?

Anyone can get an infected ear piercing, but it usually happens due to one of two major reasons, Dr. Kaplan says: Either your piercing site wasnt adequately sterilized before you were pierced, or you kinda-sorta-definitely didnt take great care of it after you were pierced.

Do only new ear piercings get infected?

What ear piercings are most likely to become infected?

Which Antibiotic Is Best For An Ear Infection

Two classes of antibiotics are commonly used to treat an ear infection.

Aminoglycosides

Aminoglycosides have been the main treatment for bacterial ear infections for decades. Two aminoglycosides used in ototopical preparations are:

Though both of the above are commonly used in the United States, only neomycin has FDA approval. Neomycin is effective for gram-positive bacteria but its effectiveness against gram-negative bacteria has declined over years, especially against Pseudomonas, the most common bacteria in ear infections.

Tobramycin is effective for Pseudomonas and other gram-negative bacteria.

Quinolones

Quinolones are the most recently introduced ototopical antibiotics. Most quinolone antibiotics in use are fluoroquinolones, which also contain an atom of fluorine. Fluoroquinolones are considered the best available treatment now for ear infections for two reasons:

  • Broad spectrum of activity against both gram-positive and gram-negative bacteria
  • Lack of ototoxicity

Following are some of the FDA-approved fluoroquinolone solutions for external ear infection from Staphylococcus aureus and Pseudomonas aeruginosa:

Ciprofloxacin

Significant Swelling And Redness

Does the site of your childs ear piercing look significantly puffier than normal? That could be a red flag for a potential infection.

Some swelling is to be expected following the trauma of an ear piercing. However, if your childs ear appears significantly large, red, and warm to the touch, it could mean that an infection is brewing.

Inflammation shouldnt last longer than a week and should be considered abnormal if it persists beyond that. If major swelling and redness havent subsided within a few days of the piercing, contact your childs doctor.

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Other Ear Infection Treatment Options

Most middle ear infections go away without any treatment within 2-3 days, while inner ear infections take a few weeks to resolve on their own.

No matter the type of ear infection, your healthcare provider may recommend treatments in addition to or in place of antibiotics to help clear the infection:

What Are Complications Of Ear Infections

Amoxicillin 500mg Capsule Dosage For Ear Infection

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

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Side Effects Of Dog Antibiotics For Ear Infection

Dog antibiotics are generally safe and effective. However, they can cause some side effects. The most common side effect of dog antibiotics is diarrhea.

This usually goes away after a few days. But if it persists or is severe, you should contact your veterinarian.

Other side effects may include vomiting, loss of appetite, and skin rashes.

Suppose your dog experiences any of these side effects. Then, dont hesitate to contact your veterinarian immediately.

Empiric Antibiotic Selection Without Tympanocentesis

The major considerations in empiric antibiotic selection for acute otitis media include comparative drug efficacy, safety, compliance potential and cost.1 Sources of information on antibiotics are often confusing and conflicting. Pharmaceutical representatives produce brochures touting their drug as effective and perhaps better in some other way .

There is little to distinguish one antibiotic from another in terms of safety profiles. All of the antibiotics used for acute otitis media are generally quite safe. Compliance, duration of therapy and cost are important issues. The main determinants of compliance appear to be frequency of dosing, palatability of the agent and duration of therapy. Less frequent doses are more desirable than more frequent doses, which interfere with daily routines. In many instances, palatability ultimately determines compliance in children.

Patients prefer a shorter course of therapy rather than the traditional 10- to 14-day courses often used in the United States. One recent survey verified that many patients and parents only continue antibiotic therapy until symptoms resolve, perhaps followed by an additional one or two days.29 The remainder of the prescription is usually saved for future use when similar symptoms arise.29

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How Is An Ear Infection Diagnosed

Once youre at the doctors office, a medical professional will look inside your ear with an otoscope to determine whether you have an infection.

Typical signs include fluid buildup in the ear canal and middle ear, along with a red and inflamed eardrum.

Depending on the severity of your symptoms, your doctor may recommend waiting a few days to see if your ear infection improves.

Some infections resolve on their own. But if the infection is severe, or if symptoms dont improve after this time, then antibiotics may be warranted.

Chronic fluid buildup without an infection warrants additional testing from an ear, nose, and throat specialist.

Its especially important to diagnose young children so that they dont encounter speech and language delays from loss of hearing.

If your doctor recommends antibiotics to treat a severe ear infection, they will likely recommend an oral treatment, such as amoxicillin .

Enhancing Healthcare Team Outcomes

Medical Myth: Ear Infections Require Antibiotics

Culture and gram stain of purulent drainage of skin infections can help aid in the treatment of skin and soft tissue infections, but this is not a requirement . Alternatively, it is not recommended to perform a swab, biopsy, or blood culture from a cellulitis infection . For abscesses, incision and drainage is the recommended treatment . For infections involved with penetrating trauma, as could be the case with a recent body piercing, treatment with antimicrobials directed against methicillin-resistant Staphylococcus aureus and Streptococcus species are recommended . Recommended treatment duration is five days, but therapy extension is advisable if not improved during that treatment period .

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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.

When To Use Antibiotics

Antibiotics are specific for the type of bacteria being treated and, in general, cannot be interchanged from one infection to another. When antibiotics are used correctly, they are usually safe with few side effects. Health care providers are able to assess each patient individually to determine the correct antibiotic, dose and length of treatment.

However, as with most drugs, antibiotics can lead to side effects that may range from being a nuisance to serious or life-threatening. In infants and the elderly, in patients with kidney or liver disease, in pregnant or breastfeeding women, and in many other patient groups, antibiotic doses may need to be adjusted based upon the individual patient. Drug interactions can also be common with antibiotics.

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What Are The Types Of Ototopical Antibiotics

Ototopical antibiotics are available in three forms:

Powders

Powders are not approved by FDA, but regionally compounded powders have been in use for years. Powders have the advantage of adhering to and remaining for a long time in moist surfaces. Powders are prepared with several components.

Two preparations of powders used are:

Creams and ointments

Creams and antibiotics are applied only for bacterial and fungal infections in the external ear and auditory canal, usually with a single dose. Following are some of the antibiotic ointments and creams used for external ear infections:

More Choices For Sinus Infections

zymox plus otic (UK stock) ear drops with 1% HC for acute otitis in ...
  • These can help shrink the blood vessels in the nasal passages and sinuses and make it easier to breath. This can also help inhaled medications get where they need to go and take away stuffiness.
  • Antihistamines: These reduce your bodys response to allergies. They lower the histamine and help reduce inflammation, congestion, and mucus production related to seasonal allergies.
  • Home Remedies: You can try warm compresses on the sinuses or humidifying the air in your room. Your doctor may also suggest plain saline nose drops to help loosen mucus.
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    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.

    Why Do Children Get Many More Ear Infections Than Adults Will My Child Always Get Ear Infections

    Children are more likely than adults to get ear infections for these reasons:

    • The eustachian tubes in young children are shorter and more horizontal. This shape encourages fluid to gather behind the eardrum.
    • The immune system of children, which in the bodys infection-fighting system, is still developing.
    • The adenoids in children are relatively larger than they are in adults. The adenoids are the small pads of tissue above the throat and behind the nose and near the eustachian tubes. As they swell to fight infection, they may block the normal ear drainage from the eustachian tube into the throat. This blockage of fluid can lead to a middle ear infection.

    Most children stop getting ear infections by age 8.

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    How Can I Prevent An Ear Infection From Occurring

    Ear infections are very common in children, but adults also have a risk of getting them. There are many ways to reduce your chances of developing an ear infection. These include not smoking, controlling allergies, keeping the ears dry , preventing colds, practicing good hygiene, and breastfeeding your baby.

    How K Health Can Help

    Antibiotic Ear Drops – When and How to Use Ear Drops Properly

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    K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

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    When Are Antibiotics Needed For Dog Ear Infections

    Inflammation of the ear canal may result in the overgrowth of yeast or bacterial populations that live on the skin in the ear canal normally. Antibiotics are needed for ear infections where bacterial overgrowth is identified. Not all ear infections require antibiotics. Your vet can advise on the best treatment based on their examination and diagnostic tests. It is important to follow your vets instructions closely and return for any recommended recheck appointments to ensure the infection has resolved completely. Lapses in your dogs treatment could lead to a recurrence of the infection.

    Dog Ear Infections Home Remedies

    You can use many home remedies to help treat a dogs ear infection. One of the most effective home remedies is to use a solution of warm water and apple cider vinegar.

    This solution can help to break down the wax buildup in the ears. And also help to kill any bacteria that may be present.

    Another effective home remedy is to use a solution of hydrogen peroxide and water. This solution can help loosen the wax buildup and kill any bacteria that may be present.

    Finally, another effective home remedy is to use a cotton ball soaked in olive oil. This can help to lubricate the ear canal. And also help to prevent further wax buildup.

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    How Long Does It Take For An Ear Infection To Heal

    On average, an ear infection can last one to two weeks depending on where it is located and how it is treated. Middle ear infections tend to go away the fastest without treatment. Inner ear infections can last a few weeks. The use of antibiotics or other treatment methods can help speed up the healing process.

    What Types Of Antibiotics Are Used

    Polysporin Antibiotic Ear Drops plus Pain Relief

    Swimmers ear is often treated with an antibiotic ear drop rather than an oral antibiotic.

    For AOM, oral treatments such as amoxicillin are common. Oral antibiotics are usually prescribed to be taken for seven to 10 days. Make sure to always finish your antibiotics, even if you feel better before you run out.

    Your doctor may not prescribe antibiotics at all, but rather opt to take a wait-and-see approach if your infection is mild. Recurring ear infections are sometimes treated surgically with ear tubes.

    For more information or to schedule an appointment with experts, call Pinnacle ENT Associates today.

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    Cdc Recommendations For Management Of Acute Otitis Media

    The Centers for Disease Control and Prevention report from the drug-resistant S. pneumoniae therapeutic working group, which included representatives of the American Academy of Family Physicians, gave specific recommendations for the treatment of acute otitis media .25 The CDC working group distinguished initial treatment options on the basis of whether or not the patient had recently received antibiotic therapy, because recent exposure clearly increases the risk of resistant pathogens.

    The rightsholder did not grant rights to reproduce this item in electronic media. For the missing item, see the original print version of this publication.

    Tympanocentesis was noted as an option in cases of treatment failure . Tympanocentesis was viewed as particularly important if a child has recently received several courses of antimicrobial therapy and is therefore more likely to harbor a multiply-resistant strain.25 In this context, the working group stated, In an era of increasing antimicrobial resistance, clinicians treating children with acute otitis media should consider developing the capacity to perform tympanocentesis themselves or establish ready referral mechanisms to a clinician with this capacity. If tympanocentesis is performed and S. pneumoniae is isolated, clindamycin then becomes a treatment option.

    What Antibiotic Treats Uti In Dogs

    Antibiotics for dogs and cats, like Cephalexin or Clavamox, are the most common treatment for UTIs due to their ability to destroy and inhibit the growth of bacteria.

    Some veterinarians recommend a follow-up urine culture after antibiotic treatment is complete to confirm that the infection has been eradicated.

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    Antibiotic Prophylaxis For Dental Work

    Your dentist may prescribe preventative antibiotics for certain dental services or before the treatment of your dental infection this is called antibiotic prophylaxis.

    During certain dental treatments, the bacteria that reside in your mouth may enter the bloodstream, and prophylactic antibiotics can prevent infection.

    What Are The Advantages Of Ototopical Antibiotics

    Ear Infection Treatment

    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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