Do You Need Antibiotics
Your physician may recommend a watch-and-see approach rather than prescribing antibiotics right away. Typically, you will keep an eye on symptoms for three days to see if they improve. This approach usually is used for children whose ear infections cannot be definitively diagnosed or who are under the age of 2.
If the infection does not clear up, you will need antibiotics. In some cases, a doctor will write you a prescription just in case the infection does not clear up.
If the ear infection is caused by a virus, antibiotics will not be prescribed because they do not work against viruses. Relieving symptoms while keeping an eye on the progression of the infection is the best course of treatment for a viral ear infection.
Making A Full Recovery
If your doctor does prescribe antibiotics for an ear infection, make sure you finish the entire dosage even if you feel better. Your infection could come back and will be more resistant to treatments.
This will ensure you will make a full recovery a quick as possible.
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How To Take Oral Antibiotics
Its important to always take your antibiotics as prescribed. It may be tempting to combine the doses, but they will not be as effective and could lead to adverse side effects, such as stomach upset.
Even if you begin to feel better, you should continue to take the antibiotics until you finish your medication to prevent the infection from returning. You should avoid alcohol while taking antibiotics.
While antibiotics are good for clearing a bacterial infection, they can also rid the body of helpful “good” bacteria at the same time. Because of this, you may want to consider taking a probiotic supplement while you are on antibiotics.
Probiotics are living organisms that can help to prevent the imbalance of bacteria within your gut that often comes from taking antibiotics. Studies have shown that taking probiotics while taking antibiotics can lower the chances of side effects from a bacterial imbalance, such as gastrointestinal upset and diarrhea.
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Ear Infection Treatment Options
Due to the variety of ear infections, patients may be given a few different treatment options. Middle ear infections do not always require prescription medication due to the bodys natural ability to fight off the infection. Your doctor or pediatrician may recommend a method of treatment called watchful waiting. This involves two to three days of rest, drinking lots of fluids, and the use of over-the-counter pain relievers as needed. If after two to three days the patient is not improving, the doctor may write a prescription for antibiotics. Alternatively, the physician may write a prescription for an antibiotic but recommend waiting two to three days before filling in case the ear infection clears up in the meantime.
In some cases, using a tympanostomy tube may be necessary to prevent fluid from building up in the ear and to assist with relieving air pressure near the eustachian tube.
Treatment For Middle Ear Infection
Symptoms of middle ear infection usually improve by themselves within 24-48 hours, so antibiotics arent often needed.
You can give your child paracetamol in recommended doses to help with pain. Your GP might suggest some anaesthetic ear drops if your child has severe pain.
If your child still has pain and is unwell after 48 hours, is particularly unwell or is less than 12 months old, your GP might prescribe a short course of antibiotics, usually penicillin.
Most children improve after a few days of antibiotic treatment, but always make sure your child finishes the whole treatment, even if she seems better. Stopping too soon could make the infection come back. Often your GP will want to see your child again when your child has finished the treatment, to make sure the infection has cleared up.
Decongestants, antihistamines and corticosteroids dont work as a treatment for middle ear infections.
Putting cotton wool in your childs ear or cleaning discharge with a cotton bud can damage the ear. It isnt recommended.
Recurrent ear infections Some children with recurrent ear infections or glue ear might need a long course of antibiotics.
Glue ear generally improves within three months. Your GP will need to monitor your child during this time to check that its getting better.
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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.
Tests For Middle Ear Infection
The GP will look carefully at the inside of your childs ear using an instrument called an otoscope.
The GP might also do a tympanometry. This test measures how much your childs eardrum can move, and it can help the GP work out whether the ear is normal. Its usually a painless test that takes just a couple of minutes.
If your child has had several ear infections, or if your doctor thinks there might be a chronic infection or glue ear, the doctor might organise a hearing test. Your child can have a formal hearing test at any age.
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What Causes Middle Ear Infections
Most middle ear infections occur when an infection such as a cold, leads to a build-up of mucus in the middle ear and causes the Eustachian tube to become swollen or blocked.
This mean mucus cant drain away properly, making it easier for an infection to spread into the middle ear.
An enlarged adenoid can also block the Eustachian tube. The adenoid can be removed if it causes persistent or frequent ear infections. Read more about removing adenoids.
Younger children are particularly vulnerable to middle ear infections as:
- the Eustachian tube is smaller in children than in adults
- a childs adenoids are relatively much larger than an adults
Certain conditions can also increase the risk of middle ear infections, including:
- having a cleft palate a type of birth defect where a child has a split in the roof of their mouth
- having Downs syndrome a genetic condition that typically causes some level of learning disability and a characteristic range of physical features
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.
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Why Do Kids Get So Many Ear Infections
The NIH points to several reasons why kids are more likely to get ear infections:
- Childrens eustachian tubes are smaller and more level than those of adults. This means its harder for fluid to drain from the ear, so if a childs tubes get blocked by mucus from another respiratory infection, fluid may not drain properly.
- Childrens immune systems are still developing so it can be harder for them to fight infections.
- In children, if bacteria gets trapped in the adenoids , it can cause a chronic infection that gets passed to the eustachian tubes and middle ear.
How Is An Ear Infection Treated
Treatment of ear infections depends on age, severity of the infection, the nature of the infection and if fluid remains in the middle ear for a long period of time.
Your healthcare provider will recommend medications to relieve you or your childs pain and fever. If the ear infection is mild, depending on the age of the child, your healthcare provider may choose to wait a few days to see if the infection goes away on its own before prescribing an antibiotic.
Antibiotics
Antibiotics may be prescribed if bacteria are thought to be the cause of the ear infection. Your healthcare provider may want to wait up to three days before prescribing antibiotics to see if a mild infection clears up on its own when the child is older. If your or your childs ear infection is severe, antibiotics might be started right away.
The American Academy of Pediatrics has recommended when to prescribe antibiotics and when to consider waiting before prescribing based on your childs age, severity of their infection, and your childs temperature. Their recommendations are shown in the table below.
American Academy of Pediatrics Treatment Guide for Acute Otitis Media
| Childs Age | ||
|---|---|---|
| in one or both ears | Mild for < 48 hours and temp < 102.2° F | Treat with antibiotic OR observe. If observe, start antibiotics if child worsens or doesnt improve within 48 to 72 hours of start of symptoms |
Pain-relieving medications
Ear tubes
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How Common Is Acute Otitis Media
Acute otitis media is predominantly an infection of young children, primarily occurring in the first three years of life. Children in the 1990s experience 30% more episodes of acute otitis media as compared with children in the 1970s, probably as a consequence of high rates of day care. Currently, acute otitis media accounts for one-fourth of all pediatric office visits in the first three years.
Nearly 94% of children will experience at least one ear infection in the first three years of life, with an average of about three episodes in the first and second years, and one and one-half episodes in the third year. As many as 5% to 8% of children will undergo the placement of ventilating tubes in their first 24 months of life. Much of this is related to the high rate of daycare attendance in the United States, with increased exposure to infectious agents.
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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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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.
Differences between middle and outer ear infections| Inner ear infection |
|---|
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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 Can I Prevent Future Ear Infections
Ear infections generally come after another illness caused by viruses or bacteria. Anything you can do to keep from getting sick or boost your immune system, should also help reduce your chance of ear infections. Here are ways to keep yourself and your family healthy:
Ear infection? Were ready to help.
Are Oral Antibiotics Used To Treat Ear Infections
Ototopical antibiotics, or antibiotics administered topically into the ear, are usually the first-line treatment for recurrent bacterial infections because they can contain a greater concentration of medication than oral antibiotics.
Some examples of ototopical antibiotics used to treat bacterial ear infections are:
- Neomycin/polymyxin b/hydrocortisone
But oral antibiotics may be prescribed to treat some bacterial ear infections, particularly when the infection spreads outside of the ear canal or in the case of severe infections and infections that last longer than 2-3 days.
Some examples of oral antibiotics used to treat ear infections are:
- Amoxicillin
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Oral Antibiotics Help Treat Swimmers Ear When:
- Infection spreads beyond the ear.
- The person has other conditions, such as diabetes, that increase the risk of complications.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
10/2013
Frequently Asked Questions About Outer Ear Infections
What is the best way to apply ear drops?What is the best way to apply ear drops?
Youll need to lie down while you put ear drops in, and it can help to have someone else put them in for you.
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Oral Antibiotics Have Risks
- Oral antibiotics are more likely to cause resistant bacteria outside the ear. When that happens, these medicines will not work as well in the future. Illnesses will be harder to cure and more costly to treat.
- Antibiotic eardrops kill the bacteria faster and more completely than oral antibiotics. Drops dont go into the bloodstream, so more medicine reaches the infection.
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.
Differences between middle and outer ear infections| 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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