What Research Is Being Done On Middle Ear Infections
Researchers sponsored by the National Institute on Deafness and Other Communication Disorders are exploring many areas to improve the prevention, diagnosis, and treatment of middle ear infections. For example, finding better ways to predict which children are at higher risk of developing an ear infection could lead to successful prevention tactics.
Another area that needs exploration is why some children have more ear infections than others. For example, Native American and Hispanic children have more infections than do children in other ethnic groups. What kinds of preventive measures could be taken to lower the risks?
Doctors also are beginning to learn more about what happens in the ears of children who have recurring ear infections. They have identified colonies of antibiotic-resistant bacteria, called biofilms, that are present in the middle ears of most children with chronic ear infections. Understanding how to attack and kill these biofilms would be one way to successfully treat chronic ear infections and avoid surgery.
Understanding the impact that ear infections have on a childs speech and language development is another important area of study. Creating more accurate methods to diagnose middle ear infections would help doctors prescribe more targeted treatments. Researchers also are evaluating drugs currently being used to treat ear infections, and developing new, more effective and easier ways to administer medicines.
How Does A Doctor Diagnose A Middle Ear Infection
The first thing a doctor will do is ask you about your childs health. Has your child had a head cold or sore throat recently? Is he having trouble sleeping? Is she pulling at her ears? If an ear infection seems likely, the simplest way for a doctor to tell is to use a lighted instrument, called an otoscope, to look at the eardrum. A red, bulging eardrum indicates an infection.
A doctor also may use a pneumatic otoscope, which blows a puff of air into the ear canal, to check for fluid behind the eardrum. A normal eardrum will move back and forth more easily than an eardrum with fluid behind it.
Tympanometry, which uses sound tones and air pressure, is a diagnostic test a doctor might use if the diagnosis still isnt clear. A tympanometer is a small, soft plug that contains a tiny microphone and speaker as well as a device that varies air pressure in the ear. It measures how flexible the eardrum is at different pressures.
Should My Child See Her Pediatrician For An Ear Infection
In some cases with older babies and toddlers, mild symptoms may go away on their own. But if your child is under 6 months old, has a high fever, severe pain, drainage or swelling in the ear, its time to call your pediatrician. However, your doctor wont necessarily prescribe antibiotics right away. Ear infections are caused by both bacteria and viruses, so antibiotics arent always the solution. According to the American Academy of Family Physicians, there are several reasons why doctors dont prescribe antibiotics for every ear infection:
- Antibiotics dont work for ear infections caused by viruses.
- Antibiotics dont help the pain associated with ear infections
- Infections from both viruses and bacteria often disappear without antibiotics in a few days, especially in children over two years old.
- Physicians are keenly aware that the overprescription of antibiotics makes vital medicines less effective, so we work hard to use them only when truly necessary. In many cases, your doctor will watch the infection for a few days to see if it goes away on its own.
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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.
Fast Facts On Ear Infections:
Here are some key points about ear infections. More detail and supporting information is available in the main article.
- Ear infections are more common in young boys than young girls.
- Most ear infections improve without treatment.
- Vaccinating a child against the flu can help prevent ear infections.
- Biofilms of antibiotic-resistant bacteria may be to blame for prolonged and repeated cases of ear infection
- Secondhand smoke increases the risk of ear infections.
An ear infection is a bacterial or viral infection of the middle ear. This infection causes inflammation and the buildup of fluid within the internal spaces of the ear.
The middle ear is a air-filled space situated behind the eardrum. It contains vibrating bones that convert sound from outside of the ear into meaningful signals for the brain.
Ear infections are painful because the inflammation and buildup of excess fluid increases pressure on the eardrum.
An ear infection can be acute or chronic. Chronic ear infections may permanently damage the middle ear.
In adults, the symptoms are simple. Adults with ear infections experience ear pain and pressure, fluid in the ear, and reduced hearing. Children experience a wider range of signs. These include:
- tugging or pulling at the ear
- ear pain, especially when lying down
- difficulty sleeping
Ear infections are generally divided into three categories.
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What Causes Ear Infections In Dogs
Ear infections in dogs can occur in the outer ear , the middle ear , or the inner ear . Dogs have a long L-shaped ear canal that easily traps dirt and moisture.
Breeds with long, floppy ears or dogs that love to swim frequently are more susceptible to ear problems, but any breed of dog can be affected. Ear infections in the outer ear are often caused by bacteria that live in the ear canal normally and help keep the skin balanced and healthy.
Something triggers the ear canal to become inflamed, allowing bacteria and yeast populations to become unbalanced and overgrown, resulting in an ear infection. Tiggers for ear infections in dogs include allergies , parasites such as ear mites, foreign objects in the ear canal such as grass seeds, and growths or tumors in the ear canal.
How Middle Ear Infections Are Treated
Most ear infections clear up within three to five days and dont need any specific treatment. If necessary, paracetamol or ibuprofen should be used to relieve pain and a high temperature.
Make sure any painkillers you give to your child are appropriate for their age. Read more about giving your child painkillers.
Antibiotics arent routinely used to treat middle ear infections, although they may occasionally be prescribed if symptoms persist or are particularly severe.
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Can Ear Infections Be Prevented
Currently, the best way to prevent ear infections is to reduce the risk factors associated with them. Here are some things you might want to do to lower your childs risk for ear infections.
- Vaccinate your child against the flu. Make sure your child gets the influenza, or flu, vaccine every year.
- It is recommended that you vaccinate your child with the 13-valent pneumococcal conjugate vaccine . The PCV13 protects against more types of infection-causing bacteria than the previous vaccine, the PCV7. If your child already has begun PCV7 vaccination, consult your physician about how to transition to PCV13. The Centers for Disease Control and Prevention recommends that children under age 2 be vaccinated, starting at 2 months of age. Studies have shown that vaccinated children get far fewer ear infections than children who arent vaccinated. The vaccine is strongly recommended for children in daycare.
- Wash hands frequently. Washing hands prevents the spread of germs and can help keep your child from catching a cold or the flu.
- Avoid exposing your baby to cigarette smoke. Studies have shown that babies who are around smokers have more ear infections.
- Never put your baby down for a nap, or for the night, with a bottle.
- Dont allow sick children to spend time together. As much as possible, limit your childs exposure to other children when your child or your childs playmates are sick.
What Are The Treatments For Ear Infections
If your pediatrician recommends antibiotics, shell usually start with amoxicillin, an effective and safe antibiotic for bacterial infections that is one of the most commonly prescribed for young children. Whether or not your doctor opts for antibiotics or a watch-and-wait approach, rest and fluids are key as with any childhood respiratory infection or virus.
For pain relief at home, your pediatrician will usually recommend Acetaminophen for babies under 6 months and Acetaminophen or Ibuprofen for children 6 months and older. Remember that according to the CDC, over-the-counter cough medicines should not be given to children under 4 and should only be given to older children with your doctors approval. Recent research has shown that the negatives of these OTC medicines often outweigh any benefits.
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What Are Symptoms Of Ear Infections
Symptoms of ear infections include:
Additional signs of ear infections in young children and infants may also include:
- Pulling on the ear/rubbing the ear
Middle ear infection is usually caused by:
- Bacteria the most common bacterial causes include:
- Streptococcus pneumoniae
- Haemophilus influenzae
Infections of the ear canal are usually caused by water that remains in the outer ear canal for an extended period of time, which, when combined with the earwax and debris already present in the ear canal, provided a moist environment for bacteria or yeast to grow and cause infection. While its commonly called swimmers ear, diving or bathing and showering can also permit just enough water into the ear to create a fertile breeding ground for infection.
What Can I Do To Prevent Antibiotic Resistance
Actions dog owners can take to reduce the growing problem of antibiotic resistance include:
- Administer oral antibiotics, or antibiotic ear drops at the correct time and at the correct dose. Read dosing instructions on the dispensing label carefully.
- Always complete the course of your dogs antibiotic, even if they seem better before the end. Antibiotic ear drops should always be used as a course and not applied to your dogs ear intermittently.
- Do not use antibiotic ear drops for repeat ear infections unless they have been prescribed by your vet for this. Even if the symptoms appear the same, the infection may be different.
- Dispose of unused antibiotics safely. Do not put them in household waste or water sources as this could lead to environmental contamination.
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What You Can Do To Soothe A Cold Or Ear Infection:
- Use acetaminophen or ibuprofen to reduce fever and head pressure.
- Try a cool-mist humidifier or shower steam to loosen congestion.
- Try over-the-counter saline drops to clear the nose.
- Consider sinus rinses or devices to remove mucus from young childrens noses.
- For children older than age 1, honey in warm water can soothe a cough.
- For older children, an extra pillow under their head can help them sleep better.
How Are Dog Ear Infections Treated
Ear infections can vary in severity and underlying cause. This determines how ear infections are treated and how quickly they resolve. For some dogs, especially those with underlying skin allergies, ear infections can become a chronic problem and require lifelong management. Treatment of outer ear infections commonly involves cleaning your dogs ears to remove wax and discharge using a medicated ear cleanser alongside topical medication. Topical medication may include anti-inflammatory drugs such as steroids to reduce inflammation, antibiotics if a bacterial infection is present and antifungal drugs if a yeast infection is present. In chronic cases, ear flushes under sedation or general anesthesia are performed to remove wax and discharge and instill medication into the ear canal.
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What Happens If An Ear Infection Is Left Untreated
Fluid buildup in the ear can be damaging even if theres no infection and may lead to a ruptured eardrum and hearing loss. So, its important to see the doctor if symptoms remain after finishing the antibiotics. Theyll likely want to take a look in your ear and learn more about your symptoms.
Depending on your symptoms, your doctor may recommend you see an ear, nose and throat doctor. The ENT doctor may recommend surgery to place small metal or plastic tubes in the ear canal to make it easier for the fluid to drain out. Your doctor may also recommend ear tube surgery for your child if they have recurrent ear infections.
What Are The Types Of Ototopical Antibiotics
Ototopical antibiotics are available in three forms:
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:
- Gold dust: comprised of chloramphenicol, sulfanilamide and hydrocortisone
- Mastoid powder: comprised of ciprofloxacin, clotrimazole, dexamethasone and boric acid
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:
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Antibiotics For Ear Infections: The Best Treatment Options
Ear infections are incredibly common in children, and they can also affect adults. Oftentimes ear infections go away in a few days without any treatment. When an ear infection is severe or doesnt resolve on its own, antibiotics may be a necessary and effective treatment.
In this article, Ill describe the different types of ear infections that affect children and adults. Then Ill discuss the antibiotics used to treat ear infections and their possible side effects.
Finally, Ill explain other treatment options, how best to prevent ear infections, and when you should speak with your doctor or pediatrician.
When To See A Doctor
Ear infections can go away on their own in many cases, so a minor earache may not be a worry.
A doctor should typically be seen if symptoms have not improved within 3 days. If new symptoms occur, such as a fever or loss of balance, a doctor should be seen immediately.
Any sign of discharge coming from the ear would also require a visit to the doctor.
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When To Talk To A Doctor
If you notice persistent ear infection symptoms that dont resolve on their own, call a healthcare professional.
This is particularly important for adults, as a middle ear infection can be a sign of a more serious problem in this age group compared to children.
And if you experience chronic ear infections, talk to your primary care provider, an otolaryngologist , or an otologist to discuss treatment options.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
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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How Can I Tell If My Child Has An Ear Infection
Most ear infections happen to children before theyve learned how to talk. If your child isnt old enough to say My ear hurts, here are a few things to look for:
- Tugging or pulling at the ear
- Fussiness and crying
- Fluid draining from the ear
- Clumsiness or problems with balance
- Trouble hearing or responding to quiet sounds
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Symptoms Of Dog Ear Infections
Some dogs do not show signs of discomfort with an ear infection, and the only external signs are a build-up of wax and discharge in the ear canal. Ear infections can affect one or both ears at the same time. Common signs of an ear injection include:
- Dark wax or discharge in the ear canal
- Foul smelling odor
- Redness and swelling of the ear canal
- Pain when the ear is touched or reluctance to allow the ear to be touched
- Head tilt to the side, which is worst affected
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:
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When Else Are Antibiotics Needed
Antibiotics can be the right treatment for kids who get a lot of ear infections. Their doctors might prescribe daily antibiotics to help prevent future infections. And younger children or those with more severe illness may need antibiotics right from the start.
The “wait-and-see” approach also might not apply to children with other concerns, such as cleft palate, genetic conditions such as Down syndrome, or other illnesses such as immune system disorders.
Where To Get Help
- NURSE-ON-CALL Tel. for expert health information and advice
- Royal Children’s Hospital Tel. 9345 5522
- Your maternal and child health nurse
- Your local hospital emergency or casualty department.
- 24 hour Maternal and Child Health Telephone Service: Tel. 13 22 29 for the cost of a local call throughout Victoria.
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