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How Can I Prevent Ear Infections
The CDC offers several tips for reducing the risk factors that contribute to ear infections. These include:
- Staying up to date on childhood vaccines including the pneumococcal vaccine that helps protect against the Streptococcus pneumoniae bacteria that can cause ear infections and the flu vaccine.
- Frequent handwashing by parents and caregivers
- Breastfeeding until at least 6 months passes on moms immunity to babies
- Avoid exposing your child to secondhand smoke
Babys first sick visit: its never fun, sometimes scary and often related to an ear infection. But dont worry if your pediatrician sends you home empty-handed at first. At Loudoun Pediatric Associates, well make sure your child gets what she needs in the case of an ear infection, whether its a round of antibiotics or a few days of rest and watchful waiting. Sometimes we need an antibiotic to give those germs the boot, but in other cases rest, fluids and lots of snuggles are the best prescription.
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When Should I See A Doctor
You should visit your doctor if:
- you or your child is in pain
- there is discharge from your or your child’s ear
- you or your child is unwell or vomiting or has a fever
- you or your child can’t hear properly
- your child gets repeated ear infections
Go to your nearest emergency department if there is redness, pain or swelling of the bone behind the ear or if the ear is pushed forward. This could be a sign of a serious infection called mastoiditis.
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What Causes An Ear Infection
An ear infection usually is caused by bacteria and often begins after a child has a sore throat, cold, or other upper respiratory infection. If the upper respiratory infection is bacterial, these same bacteria may spread to the middle ear if the upper respiratory infection is caused by a virus, such as a cold, bacteria may be drawn to the microbe-friendly environment and move into the middle ear as a secondary infection. Because of the infection, fluid builds up behind the eardrum.
How Do Cotton Swabs Cause Outer Ear Infections
Dr. Wang: Earwax is a natural way for your body to trap and slow the growth of bacteria that may have entered your ear. When you apply cotton swabs, you often wind up pushing earwax further into the ear canal. This impacted wax can then trap water or moisture deep in the canal, setting you up for an infection.
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Treating Outer Ear Infections
Outer ear infections are sometimes called swimmer’s ear, or otitis externa. This is an infection of the ear canal, the portion of the ear that leads from the outside and stops at the eardrum. The opening of this part of the ear is external and visible.
Outer ear infections are called swimmer’s ear because they can sometimes be caused by swimming or bathing in contaminated water.
This is not the only way to get an outer ear infection, however. Bacteria, viruses, or fungi can be introduced to the outer ear in many ways, especially through broken skin, and usually result in an infection when a moist environment aids their growth.
Symptoms of an outer ear infection can include:
- Pain in the ear
- Redness and irritation inside the ear canal
- Itchy ear canal
- Flaky or peeling skin
More severe infections can lead to swelling of the ear canal, which may lead to muffled hearing, a fever, or ear drainage that looks like there is pus in it.
An outer ear infection can be diagnosed through an examination of the ear canal with an otoscope .
What Are The Best Home Remedies For Ear Infections
Since watchful waiting is a fairly common approach to treating ear infections, home remedies are popular for treating this common condition. There are many different sworn methods out there for treating everything from the earache or ear pain to the infection itself. However, it is important to remember that if untreated by a medical professional, some ear infections can result in a worsening condition such as a ruptured eardrum or hearing loss. Some of the commonly used home remedies for ear infections include:
- Cold or warm compress: Using a cold or warm compress on the affected ear can help reduce inflammation and alleviate pain. Patients may notice more success by alternating between both a cold compress and warm compress every 10 minutes or so. However, simply using one or the other should make some difference in the condition.
- Changes to sleep positions: Some ear infections are made worse by sleeping in a way that irritates the affected ear. By sleeping with the infected ear raised instead of down it can help relieve pressure and may allow it to drain more easily or prevent fluid buildup.
- Olive oil: While it is an older remedy, olive oil is said to have some soothing properties. It is used by putting just a few warmed drops in the patients ear. It may have some soothing benefits. However, given that it isnt a studied treatment for ear infections it might be a better option to use in combination with other home remedies.
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How Are Outer Ear Infections Treated
Dr. Wang: Most ENT doctors and primary care physicians will prescribe antibiotic ear drops only. Typically, oral antibiotics are not necessary, and we like to avoid overprescribing them so they continue to work when we actually need them. Occasionally, the opening of the ear may be too inflamed or sticky to get the drops in, so we have to stick a little wick in there to get the drops where they need to go. The provider may prescribe oral antibiotics if the outer ear infection is really severe.
When Should I Call The Doctor About An Ear Infection
- You or your child develops a stiff neck.
- Your child acts sluggish, looks or acts very sick, or does not stop crying despite all efforts.
- Your childs walk is not steady he or she is physically very weak.
- You or your childs ear pain is severe.
- You or your child has a fever over 104° F .
- Your child is showing signs of weakness in their face .
- You see bloody or pus-filled fluid draining from the ear.
- The fever remains or comes back more than 48 hours after starting an antibiotic.
- Ear pain is not better after three days of taking an antibiotic.
- Ear pain is severe.
- You have any questions or concerns.
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What Are The Symptoms Of A Middle
Common symptoms of a middle-ear infection in adults are:
Pain in 1 or both ears
Drainage from the ear
You may also have a fever. Rarely, your balance can be affected.
These symptoms may be the same as for other conditions. Its important totalk with your health care provider if you think you have a middle-earinfection. If you have a high fever, severe pain behind your ear, orparalysis in your face, see your provider as soon as you can.
Causes Of Outer Ear Infection
Outer ear infections are usually caused by bacteria or fungi. But anything that irritates the skin of your ear canal or causes an allergic reaction can also cause inflammation.
Certain things may make you more likely to get an outer ear infection.
- Damage to your ear canal from a cotton bud, your fingernail or any other object.
- A build-up of earwax or accidently pushing earwax into your ear when cleaning it.
- Having too little earwax, often from too much cleaning. Some earwax is healthy, as it protects the lining of your ear canal from dirt and dust and infections.
- Using hearing aids or earplugs these can damage or irritate your ear canal or introduce bacteria.
- Swimming, especially in polluted water because this may introduce bacteria into your ear.
- Living in a hot, humid climate ear infection is often known as tropical ear.
- Having allergies or being sensitive to products like hairsprays and hair dyes these can irritate your ear canal.
- Having a narrow ear canal, which means that water can become trapped and bacteria are more likely to grow.
- Having a skin condition such as eczema or psoriasis broken skin is more likely to become inflamed.
- Having a condition that affects your immune system for example, HIV/AIDS.
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Are There Any Differences In Getting Ear Tubes As An Adult Versus As A Child Do You Still Have To Avoid Swimming
Dr. Wang: They function pretty much the same for kids as adults. You still have to have relative water precautions. You can swim but it may be safest to use ear plugs or a swim band to keep water out. The main difference is adults typically do fine with ear tube placement in the office. There’s no need for an OR or general anesthesia like there traditionally has been for kids. Actually, there’s a new procedure for placing ear tubes in kids that allows us to do it super quickly with local anesthesia only. So now we can do that in clinic as well.
What Are The Advantages Of Ototopical Antibiotics
Administration of antibiotics directly in the ear has several advantages over systemic delivery including the following:
- 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
- Ototopical antibiotics are generally less expensive than comparable systemic medications.
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How Are Middle Ear Infections Treated
Dr. Wang: Frontline treatment for middle ear infections is a course of oral antibiotics. Sometimes steroids can be added if the pain is severe, which doesn’t help resolve the infection any faster but can reduce the inflammation and pressure causing the pain. If you’ve been on standard treatments for several days but your ear still aches or feels full, you should be referred to an ENT, who may recommend different medications or elect to lance the eardrum to remove the fluid. If you keep getting middle ear infections, you may have to have ear tubes placed in your ears, just like we do with children.
About Middle Ear Infections
Otitis media is an infection of the middle ear that causes inflammation and a build-up of fluid behind the eardrum.
Anyone can develop a middle ear infection but infants between six and 15 months old are most commonly affected.
It’s estimated that around one in every four children experience at least one middle ear infection by the time they’re 10 years old.
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What Is An Ear Infection
There are different types of ear infections. Middle ear infection is an infection in the middle ear.
Another condition that affects the middle ear is called otitis media with effusion. This condition occurs when fluid builds up in the middle ear without causing an infection. Otitis media with effusion does not cause fever, ear pain, or pus build-up in the middle ear.
Swimmers ear is an infection in the outer ear canal. Swimmers Ear is different from a middle ear infection. For more information, visit Swimmers Ear .
Who Is Most Likely To Get An Ear Infection
Middle ear infection is the most common childhood illness . Ear infections occur most often in children who are between age 3 months and 3 years, and are common until age 8. Some 25% of all children will have repeated ear infections.
Adults can get ear infections too, but they dont happen nearly as often as they do in children.
Risk factors for ear infections include:
- Age: Infants and young children are at greater risk for ear infections.
- Family history: The tendency to get ear infections can run in the family.
- Colds: Having colds often increases the chances of getting an ear infection.
- Allergies: Allergies cause inflammation of the nasal passages and upper respiratory tract, which can enlarge the adenoids. Enlarged adenoids can block the eustachian tube, preventing ear fluids from draining. This leads to fluid buildup in the middle ear, causing pressure, pain and possible infection.
- Chronic illnesses: People with chronic illnesses are more likely to develop ear infections, especially patients with immune deficiency and chronic respiratory disease, such as cystic fibrosis and asthma.
- Ethnicity: Native Americans and Hispanic children have more ear infections than other ethnic groups.
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How To Administer Antibacterial Ear Drops
Antibiotic ear drops are for the ears only and should never be put into the eyes. Always take the entire prescribed amount even if your symptoms improve as it prevents a recurrence of the infection.
Follow these steps to correctly administer ear drops:
- Warm the bottle in your hand for two minutes, inserting cold ear drops can cause dizziness
- Wash your hands
- Have the person with the ear infection lie on their side with the problem ear up
- For children three years and older, gently pull the outer ear outward and upward in the direction toward the top of their head
- For children younger than three years, gently pull the outer eat outward and downward in the direction toward their feet
- Without allowing the dropper to touch the ear, carefully put the drops in the ear
- Remain laying on their side for two minutes or put a cotton plug in the ear
How Do You Prevent Ear Infections
You may be able to prevent ear some ear infections if you:
- Use earplugs when swimming or diving
- Dry ears thoroughly after swimming
- Never use cotton swabs inside the ear canal
- Wash hands properly to prevent the spread of viruses
- Use soap and warm water and wash for at least 20 seconds
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Which Antibiotic Is Best For An Ear Infection
Two classes of antibiotics are commonly used to treat an ear infection.
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 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:
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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