When To Contact A Medical Professional
Contact your provider if:
- You have swelling behind the ear.
- Your symptoms get worse, even with treatment.
- You have high fever or severe pain.
- Severe pain suddenly stops, which may indicate a ruptured eardrum.
- New symptoms appear, especially severe headache, dizziness, swelling around the ear, or twitching of the face muscles.
Let the provider know right away if a child younger than 6 months has a fever, even if the child doesn’t have other symptoms.
Is An Ear Infection Contagious
To some degree, the bacteria that cause ear infections are contagious because they may colonize, or set up residence, in the nose of children or close contacts. However, only a small proportion of children colonized with a new strain of bacteria will develop an ear infection. For example, in the case of pneumococcus, only about 15% of children colonized in the nose with a new strain of it will develop an ear infection, and usually only within the first month. Also, some bacterial strains appear more aggressive than others and will directly invade the middle ear.
What may be even more important than new bacterial colonization is the spread of respiratory viruses, particularly among children in daycare and pre-schools. Respiratory viruses are very contagious in close quarters. They frequently make a child more susceptible to an ear infection by upsetting the normal balance between the child’s local nose immunity and the co-inhabitant bacteria. When the child’s defenses are down, or the eustachian tube becomes clogged, the bacteria tend to infect the middle ear.
Diagnosis Of Ear Infections
The first thing to know about ear infections is that it’s not always clear a child actually has one, even to a doctor. It seems it should be a straightforward thing to diagnose: You look inside a child’s ear and you can see if it’s infected or not, right? But it can be tough to get a clear view of the inside of a younger child’s ear. And it’s easy to mistake fluid in the ear for an infection, to label redness caused by fever or crying as a sign of infection, or to not be able to even see the eardrum because of ear wax.
One clue that a kid truly has an ear infection is that she’s also had some of the classic symptoms: rapid onset of an earache , pulling on the ear , irritability, the drainage of fluid from the ear , and fever.
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Down Syndrome & Increased Risk Of Ear Infections
Children with Down syndrome or cleft palate disorders are at much higher risk of ear infections and glue ear. They get it at a younger age and are less likely to clear it themselves. Refer early and they often need ongoing specialist review. Assessment and surgical management of otitis media with effusion in children National Institute of Healthcare Excellence, UK
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Prevention Of Middle Ear Infection
Many children who get recurrent ear infections have grommets put into their eardrums to prevent infection. Grommets are special ventilating tubes that stop fluid from building up behind the eardrum and help preserve hearing. If your child needs grommets, hell see an ear, nose and throat specialist.
Avoid smoking. Children who are exposed to second-hand smoke are more likely to develop a range of illnesses, including middle ear infections.
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How Do You Know If Your Child Has An Ear Infection
Children with an ear infection display a wide range of symptoms, from none at all, to a high fever, to a screaming earache. Many infants and toddlers with an ear infection show less obvious symptoms, such as sleeplessness, irritability, decreased feeding, or a fever. Ear pain and ear tugging are helpful clues, but are fairly unreliable. Even in older children with a respiratory illness, mild to moderate ear complaints and earaches frequently occur in children with normal ears. In these children, a sore throat often causes the ear complaints. Fever occurs in only one-fourth of ear infections, and it does not signify an ear infection.
One of the more reliable indicators of an ear infection in younger children is when a child, who has had a cold and a runny nose for three to seven days, suddenly develops sleeplessness and inconsolability during the night, along with increasing fussiness throughout the day. Children with a persistent ear infection who have recently received antibiotics often show few symptoms.
How Is A Perforated Eardrum Diagnosed
To check for a perforated eardrum, doctors check the ear canal with a lighted instrument called an otoscope. Often, a doctor can see the tear and sometimes the tiny bones of the middle ear. In some cases, fluid draining from the ear can make it hard to see the eardrum.
The doctor also might:
- order an audiology exam to measure how well the child hears at different pitches and volumes
- order a tympanometry to measure the response of the eardrum to slight changes in air pressure
- send a sample of fluid draining from the ear to a lab to check for infection
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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.
What Are The Symptoms Of Ear Infections
Ear infections can be very painful. While older children can tell you this, younger ones cant. You might see them pulling at or poking their ear. Children also might develop a fever, vomiting or problems with their balance.
An outer ear infection can make the ear and the area around it red, swollen and painful to touch.
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Ear Infection Antibiotics List For Babies
According to the AAP guidelines all babies under 6 months who develop an ear infection should be treated with antibiotics. This makes it easier for bacteria and viruses to enter them and for the tubes to become blocked.
Ear Infections Are One Of The Most Common Ailment Children And Adults Suffer Chronically Ear Infection Remedy Ear Infection Ear Infection Symptoms
What Medicines Treat Otitis Media
Some children will get better without specific antibiotic treatment, as many ear infections are viral in nature and do not need an antibiotic. However, doctors typically prescribe antibiotics in infants under 6 months of age, and for recurrent ear infections or severe symptoms. However, using antibiotics too often can cause bacteria to become resistant to the medicine.
The American Academy of Pediatrics and the American Academy of Family Physicians recommend a “wait-and-see” approach for children:
- 6 to 23 months of age with a temperature less than102.2 F and middle ear pain in one ear for less than 48 hours
- 24 months and older with mild middle ear pain in one or both ears for less than 48 hours and a temperature less than 102.2 F
Parents will follow-up with the doctor in 2 to 3 days with the wait-and-see approach. Some doctors will still prescribe antibiotics in children under 2 years with AOM. In more serious cases in older children, when there is recent high fever, both ears are affected, or ear drainage, an antibiotic treatment may be appropriate. Talk with your doctor about the potential benefits and risks of using antibiotics.
Antibiotic choice should be based on effectiveness, patient-specific needs like allergies, taste or dosage form preference, dosing convenience and cost. Its important to remember that although most antibiotics used for ear infections are very safe, there may still be side effects such as diarrhea or rash from antibiotic use.
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What Does The Eardrum Look Like When It Is Infected
When a doctor examines the eardrum through the otoscope instrument, the eardrum normally appears as a thin gray, translucent membrane . When infected, it will look opacified , very reddened, and yellowish. Sometimes, it shows a small layer of pus-like material. During an infection, the eardrum usually becomes rigid because of the accumulation of fluid, and it will not wiggle when the doctor puffs a small amount of air against the eardrum with an otoscope. Use of tympanometry or acoustic reflectometry may help to determine if there is fluid behind the eardrum. Neither instrument distinguishes between infected or uninfected fluid.
From the appearance of the eardrum, the doctor cannot determine the type of bacteria, or whether bacteria or viruses are causing the infection. The eardrum in children with otitis media with effusion appears as an orangish or dull, straw-colored fluid, and it also does not move when air is applied to it.
What Research Is Being Done
The most important recent development to potentially reduce the frequency of ear infections is a new pneumococcal conjugate vaccine. A study from Northern California suggests that this vaccine could prevent about 7% of overall episodes of ear infections, and up to 23% of recurrent ear infections.
The new pneumococcal vaccine contains 7 of 90 types of pneumococcus, which are the most common and the most resistant bacteria. Elimination of these resistant types could have an impact on the number of antibiotic failures in children. This also could mean a reduction in the placement of tubes, possibly by one-fourth, as observed in the California study.
This vaccine is administered to infants at 2, 4, 6, and 12 months of age. Side effects have been minimal, and it has been a very safe vaccine. It uses the same technology as the universally administered HIB vaccine.
Some new antibiotics are about to undergo testing in children with acute otitis media. In preliminary testing, these drugs appear to work against the resistant pneumococcus.
About the Author
Dr. Block is a full-time practicing pediatrician in rural Bardstown, Kentucky who serves on the clinical faculties at both the University of Kentucky and the University of Louisville as an Associate Clinical Professor of Pediatrics.
His pediatric practice is one of the leading pediatric research groups in the United States and, in fact, Dr. Block was awarded the American Academy of Pediatrics 1998 Practitioner Research Award.
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Who Gets Ear Infections
Ear infections are very common in babies and young children who are more likely to develop them than older children and adults. This is because their eustachian tubes don’t function as well as in older children and adults – the tubes are smaller, shorter and flatter .
As children grow older, their eustachian tubes work better and they get fewer colds. As a result, they outgrow the tendency to have ear infections at around 7 years of age. But, some children may have problems beyond this age.
When Not To Use Antibiotics
Antibiotics are not the correct choice for all infections. For example, most sore throats, cough and colds, flu, COVID or acute sinusitis are viral in origin and do not need an antibiotic. These viral infections are self-limiting, meaning that your own immune system will usually kick in and fight the virus off.
Using antibiotics for viral infections can increase the risk for antibiotic resistance. Antibiotic-resistant bacteria cannot be fully inhibited or killed by an antibiotic, even though the antibiotic may have worked effectively before the resistance occurred. This can also lower your options for effective treatments if an antibiotic is needed eventually due to a secondary infection. Using unnecessary antibiotics also puts you at risk for side effects and adds extra cost.
It’s important not to share your antibiotic or take medicine that was prescribed for someone else, and don’t save an antibiotic to use the next time you get sick. It may not be the right drug for your illness.
To better understand antibiotics, its best to break them down into common infections, common antibiotics, and the top antibiotic classes as listed in Drugs.com.
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Infections Inside The Ear
Antibiotics are not usually offered because infections inside the ear often clear up on their own and antibiotics make little difference to symptoms, including pain.
Antibiotics might be prescribed if:
- an ear infection does not start to get better after 3 days
- you or your child has any fluid coming out of the ear
- you or your child has an illness that means there’s a risk of complications, such as cystic fibrosis
They may also be prescribed if your child is less than 2 years old and has an infection in both ears.
Join The Drugscom Otitis Media Support Group
While you should only follow the medical advice of your doctor, you might consider joining the Drugs.com Otitis Media Support group to ask questions and share experiences with those who have similar questions and concerns about ear infections. You can also keep up with the latest ear infection news and approvals in the Drugs.com Otitis Media Support Group.
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Baby Vs Antibiotic Resistance
Sinus infections. Strep throat. Ear infections. The list of bacterial afflictions goes on and on, and you fight them the best way you know howwith antibiotics. But what happens when antibiotic-resistant bacteria disarm your trusted defense and leave baby vulnerable? The consequences can be long term with antibiotic resistance on the rise as a major global health threat.
Why Are Children More Likely Than Adults To Get Ear Infections
There are several reasons why children are more likely than adults to get ear infections.
Eustachian tubes are smaller and more level in children than they are in adults. This makes it difficult for fluid to drain out of the ear, even under normal conditions. If the eustachian tubes are swollen or blocked with mucus due to a cold or other respiratory illness, fluid may not be able to drain.
A childs immune system isnt as effective as an adults because its still developing. This makes it harder for children to fight infections.
As part of the immune system, the adenoids respond to bacteria passing through the nose and mouth. Sometimes bacteria get trapped in the adenoids, causing a chronic infection that can then pass on to the eustachian tubes and the middle ear.
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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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What Causes Acute Otitis Media
Acute otitis media usually is caused by one of four bacteria:
The pneumococcus bacteria is now the most difficult to treat. Some strains have become very resistant to antibiotics by using their unique ability to transform their genes and cell wall into a bacterial form, which is resistant to most of the antibiotics that commonly are used to treat ear infections. These resistant strains frequently are cultured from children who do not respond to several courses of antibiotics. When a child has an ear infection that does not respond to antibiotics, resistant pneumococcus bacteria may cause it.
Pneumococcus has 90 different types, which are all genetically related however, 7 types account for the majority of ear infections in childhood and nearly all of the antibiotic resistant strains. In addition, pneumococcus is the leading cause of meningitis, bloodstream infections, and serious pneumonia in children, sometimes as a result of a preceding ear infection.
Up to half of Haemophilus and nearly all Moraxella bacteria produce an enzyme , which makes these bacteria resistant to some of the commonly used antibiotics. This enzyme may destroy many antibiotics when they come in contact with the bacteria. Nonetheless, several available antibiotics are still quite effective against these strains.
