Monday, November 21, 2022

What Antibiotics Are Given For An Ear Infection

Risk Factors For Ear Infections

Medical Myth: Ear Infections Require Antibiotics

Ear infections occur most commonly in young children because they have short and narrow Eustachian tubes. About of children develop an acute ear infection at some point.

Infants who are bottle-fed also have a higher incidence of ear infections than their breastfed counterparts.

Other factors that increase the risk of developing an ear infection are:

  • altitude changes

What Are Other Causes Of Ear Pain

Other causes of ear pain include:

  • A sore throat.
  • Teeth coming in in a baby.
  • An infection of the lining of the ear canal. This is also called swimmers ear.
  • Pressure build up in the middle ear caused by allergies and colds.

Last reviewed by a Cleveland Clinic medical professional on 04/16/2020.

References

Duration Of Antibiotic Treatment

If a child needs antibiotics for acute otitis media, the drugs should be taken for the following periods of time:

  • A 10-day course of antibiotics is usually recommended for children younger than 2 years of age, and for those with severe symptoms.
  • A 7-day course is recommended for children 2 to 5 years of age with mild or moderate AOM.
  • A 5 to 7-day course is recommended for children 6 years of age and older with mild-to-moderate symptoms.

Parents should be sure their child finishes the entire course of therapy.

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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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What About Antibiotic Resistance

Symptoms Of Sinus Or Ear Contamination

Resistance rates for antibiotics are always variable based on local patterns in the community and specific risk factors for patients, such as recent antibiotic use, hospital stay or travel. If you have taken an antibiotic in the last 3 months or traveled internationally, be sure to tell your doctor.

High rates of antibiotic resistance are being seen with both ampicillin and amoxicillin for cystitis , although amoxicillin/clavulanate may still be an option. Other oral treatments with reported increasing rates of resistance include sulfamethoxazole and trimethoprim and the fluoroquinolones. Resistance rates for the oral cephalosporins and amoxicillin/clavulanate are still usually less than 10 percent.

Always finish taking your entire course of antibiotic unless your doctor tells you to stop. Keep taking your antibiotic even if you feel better and you think you don’t need your antibiotic anymore.

If you stop your treatment early, your infection may return quickly and you can develop resistance to the antibiotic you were using previously. Your antibiotic may not work as well the next time you use it.

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Does Cranberry Juice Prevent A Uti

Some patients may want to use cranberry or cranberry juice as a home remedy to treat a UTI. Cranberry juice has not been shown to cure an ongoing bacterial infection in the bladder or kidney.

Cranberry has been studied as a preventive maintenance agent for UTIs. Studies are mixed on whether cranberry can really prevent a UTI. Cranberry may work by preventing bacteria from sticking to the inside of the bladder however, it would take a large amount of cranberry juice to prevent bacterial adhesion. More recent research suggests cranberries may have no effect on preventing a UTI

  • According to one expert, the active ingredient in cranberries — A-type proanthocyanidins — are effective against UTI-causing bacteria, but is only in highly concentrated cranberry capsules, not in cranberry juice.
  • However, cranberry was not proven to prevent recurrent UTIs in several well-controlled studies, as seen in a 2012 meta-analysis of 24 trials published by the Cochrane group.
  • While studies are not conclusive, there is no harm in drinking cranberry juice. However, if you develop symptoms, see your doctor. Some people find large quantities of cranberry juice upsetting to the stomach.

Increasing fluid intake like water, avoiding use of spermicides, and urinating after intercourse may be helpful in preventing UTIs, although limited data is available.

How Is An Acute Middle Ear Infection Treated

Many doctors will prescribe an antibiotic, such as amoxicillin, to be taken over seven to 10 days. Your doctor also may recommend over-the-counter pain relievers such as acetaminophen or ibuprofen, or eardrops, to help with fever and pain.

If your doctor isnt able to make a definite diagnosis of OM and your child doesnt have severe ear pain or a fever, your doctor might ask you to wait a day or two to see if the earache goes away. The American Academy of Pediatrics issued guidelines in 2013 that encourage doctors to observe and closely follow these children with ear infections that cant be definitively diagnosed, especially those between the ages of 6 months to 2 years. If theres no improvement within 48 to 72 hours from when symptoms began, the guidelines recommend doctors start antibiotic therapy. Sometimes ear pain isnt caused by infection, and some ear infections may get better without antibiotics. Using antibiotics cautiously and with good reason helps prevent the development of bacteria that become resistant to antibiotics.

If your doctor prescribes an antibiotic, its important to make sure your child takes it exactly as prescribed and for the full amount of time. Even though your child may seem better in a few days, the infection still hasnt completely cleared from the ear. Stopping the medicine too soon could allow the infection to come back. Its also important to return for your childs follow-up visit, so that the doctor can check if the infection is gone.

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Common Types Of Ear Infections

The two most common types of ear infections are in the middle ear or the outer ear.

An infection in the middle ear often follows a cold or respiratory problem. The infection moves to the ears through the eustachian tubes causing them to swell.

Infections in the outer ear sometimes referred to as swimmers ear are usually caused by an outside source such as water. If water sits in the ear for too long, it can cause the skin to break down and become a breeding ground for bacteria.

Seek medical attention immediately if you have nausea, dizziness, or vomiting along with ear pain. You may have a more serious issue with your inner ear.

What You Should Not Do To Soothe A Cold Or Ear Infection:

Antibiotic Awareness: Ear Infection or Acute Otitis Media
  • Do not give over-the-counter cold medicines to children under age 2. Consider avoiding them if the child is older, too.
  • Do not tilt an infants crib mattress. Children under age 1 should sleep on a flat mattress with no pillows or blankets.
  • Do not allow a child to drink while lying down, as it can increase the chances of getting an ear infection.
  • Do not smoke. Families and caregivers who smoke increase a childs chance of getting colds and ear infections.

Because young children get more colds in the winter, they may also develop more ear infections. Five out of six children will experience at least one ear infection by the time they are 3 years old, according to the National Institutes of Health.

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Hearing Loss And Speech Or Developmental Delay

Severe cases of recurrent acute otitis media or persistent otitis media with effusion may impair hearing for a period of time. But the hearing loss is not substantial or permanent for most children.

Hearing loss in children may temporarily slow down language development and reading skills. However, uncomplicated chronic middle ear effusion generally poses no danger for developmental delays in otherwise healthy children.

Rarely, patients with chronic otitis media develop involvement of the inner ear. In these situations, hearing loss can potentially be permanent. Most of these patients will also have problems with vertigo .

When Are Antibiotics Usually Prescribed

Antibiotics are normally only prescribed for more serious infections with germs .

Most common infections are caused by viruses, when an antibiotic will not be of use. Even if you have a mild bacterial infection, the immune system can clear most bacterial infections. For example, antibiotics usually do little to speed up recovery from most ear, nose and throat infections that are caused by bacteria.

So, do not be surprised if a doctor does not recommend an antibiotic for conditions caused by viruses or non-bacterial infections, or even for a mild bacterial infection.

However, you do need antibiotics if you have certain serious infections caused by bacteria, such as meningitis or pneumonia. In these situations, antibiotics are often life-saving. When you are ill, doctors are skilled at checking you over to rule out serious illness and to advise if an antibiotic is needed. Urine infections also commonly need antibiotics to prevent spread to the kidneys.

Antibiotics can also be prescribed to treat acne – a less serious condition. For acne, antibiotics can be taken by mouth or applied directly to the skin.

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Which Antibiotic Should Be Used To Treat A Uti

There are multiple types of antibiotics used to treat urinary tract infections . Different treatments may be recommended in different areas of the country based on regional patterns of antibiotic resistance.

Most patients with an uncomplicated UTI will begin treatment without any special diagnostic test, although a urinalysis may be performed by taking a urine sample. In a urinalysis, the chemical components of the urine are determined, and the doctor may look at urine color, clarity, and a view a sample under the microscope. A urine culture may be order, too, but is not always needed to start treatment. A urine culture can define the specific bacteria causing the UTI in more complicated cases or in the case of treatment failure.

Symptoms like burning and stinging while urinating will usually clear up in within one day after starting treatment. Be sure to finish your entire course of medication. If symptoms are still present after 2 to 3 days, contact your healthcare provider.

More extensive diagnostic procedures or imaging tests like an X-ray may be required if you continue to have frequent UTIs.

How Is An Ear Infection Diagnosed

What is the best antibiotic for an ear infection?

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 .

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How Do I Know If My Child Has An Ear Infection

Older children will complain of significant ear pain and may have a fever. They may also feel unwell and complain of reduced hearing in the affected ear. In babies and younger children, sometimes the only sign of an ear infection is a fever.

If the ear infection causes an earache, your baby or child may:

  • cry and become distressed, upset and harder to settle
  • become clingy or grizzly
  • keep touching an ear again and again.

Older children may have problems with balance.

Who Shouldn’t Use Ear Drops

Ear drops can be helpful when treating an ear infection, but there are times when you shouldnât use them. For example, if you or your child has a perforated eardrum, you should avoid the use of certain ototoxic ear drops because fluid from the drops can get deep into the ear and cause more problems.

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Algorithm For Use Of Antibiotics In Acute Sinusitis

Adapted from Chow AW, Benninger MS, Brook I, et al: IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clinical Infectious Diseases 54 :10415 .

In exacerbations of chronic sinusitis in children or adults, the same antibiotics are used, but treatment is given for 4 to 6 weeks. The sensitivities of pathogens isolated from the sinus exudate and the patients response to treatment guide subsequent therapy.

Sinusitis unresponsive to antibiotic therapy may require surgery to improve ventilation and drainage and to remove inspissated mucopurulent material, epithelial debris, and hypertrophic mucous membrane. These procedures usually are done intranasally with the aid of an endoscope. Chronic frontal sinusitis may be managed either with osteoplastic obliteration of the frontal sinuses or endoscopically in selected patients. The use of intraoperative computer-aided surgery to localize disease and prevent injury to surrounding contiguous structures has become common. Nasal obstruction that is contributing to poor drainage may also require surgery.

Treatment For Acute Otitis Media

Antibiotics Best for Ear Infections?

Most cases of AOM clear up on their own within a week and do not require antibiotic treatment. Doctors often recommend a “watchful waiting” period for the first 48 to 72 hours after symptoms appear, to see if ear pain and other symptoms resolve on their own.

For antibiotic treatment, the latest recommendations are:

  • Children younger than 6 months of age should receive immediate antibiotic treatment.
  • Children 6 months or older should be treated for pain within the first 24 hours with either acetaminophen or ibuprofen . Pain relievers — not antibiotics — are the main drugs used for AOM treatment.
  • For children, aged 6 months to 2 years old, antibiotic treatment is recommended for either severe symptoms or for non-severe symptoms that have not improved within 48 to 72 hours. Severe AOM symptoms include moderate to severe pain and a fever of at least 102.2°F .
  • For children older than 2 years, and those with mild symptoms or infection only in one ear, watchful waiting is recommended.
  • Preventive antibiotics are not recommended for recurrent acute otitis media.

Ear tube insertion is an option for children who have had at least 3 occurrences of AOM in 6 months or 4 episodes in a year. However, newer guidelines strongly advise that tympanostomy tube surgery should be used only for children who have middle-ear effusion and not for children with frequent AOM infections.

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Treatment For Otitis Media With Effusion

Otitis media with effusion is fluid behind the middle ear . It usually resolves on its own without treatment, especially when it follows an acute ear infection. Antibiotics are not helpful for most cases of OME.

Clinical practice guidelines for OME recommend the following treatments:

  • Watchful Waiting for OME. The child is typically monitored for the first 3 months. If OME lasts longer than 3 months, a hearing test should be conducted. Even if OME lasts for longer than 3 months, the condition generally resolves on its own without any long-term effects on language or development. The doctor will re-evaluate the child at periodic intervals to determine if there is risk for hearing loss.
  • Drug Treatment. Antibiotics, decongestants, antihistamines, and corticosteroids do not help and are not recommended for routine management of OME. Antibiotic ear drops are helpful for treating ear infections that may occur in children with tympanostomy tubes. Topical antibiotics work better than oral antibiotics for treating the discharge that can occur with this type of infection.
  • Surgery. Ear tube insertion may be recommended when fluid builds up behind your child’s eardrum and does not go away after 3 months or longer. Fluid buildup may cause some hearing loss while it is present. However, most children do not have long-term damage to their hearing or their ability to speak even when the fluid remains for many months.

Tonsillectomy is not recommended for OME treatment.

Lets Review The Current Guideline

The American Academy of Pediatrics updated their recommendations for treatingchildhood ear infections in 2013. The current guideline, based on clinical studies and expertopinion, states that a full ten days of antibiotics may not be necessary for children over twoyears of age with non-severe ear infections. For these kids, five to seven days of antibiotics maybe enough. However, children over two years of age with a severe ear infection and kids with another bacterialinfection at the same time as the ear infection may still requirethe full ten days of antibiotics.

While antibiotics are great for fighting certain infections, they can also kill your bodys normal,good bacteria and contribute to the development of resistant bacteria, which means aparticular antibiotic is less likely to work the next time you need it. Antibiotics may cause sideeffects and increase the cost of fighting an infection. When an antibiotic is given for a shorterduration, your child is less likely to experience these negative effects.

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Which Common Infections Require Antibiotics

Patients often ask doctors for antibiotics, not knowing whether antibiotics actually treat those conditions. And doctors tend to over-prescribe antibiotics for conditions that dont always require them. Below, well talk about some common infections and what you should know about treating them.

Colds and flu

Colds and the flu are caused by viruses, so antibiotics wont help. Instead, youll want to focus on managing your symptoms. If you have the flu, your doctor may recommend an antiviral medication like .

If your cold or flu lasts for 2 weeks or more, you may be more likely to develop a bacterial sinus infection or pneumonia. In these cases, its important to visit the doctor to talk about your symptoms. If they prescribe antibiotics, its because youve developed a bacterial infection on top of your cold or flu.

Sinus infections

Sinus infections occur when fluid builds up in the air-filled pockets in your face , allowing germs to grow. Symptoms include pain or pressure in your face, a runny or stuffy nose, headache, and mucus dripping down the back of your throat.

Urinary tract infections

Common antibiotics doctors prescribe for UTIs are , , and .

Sore throat, strep throat, and tonsillitis

Inflammation of your throat or tonsils can cause soreness and pain, and you may or may not need antibiotics to treat it. If your sore throat is caused by a virus , you wont need antibiotics. But when its due to bacteria, as in strep throat and bacterial tonsillitis, you will.

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