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.
Longer Term Effects Of Inner Ear Infections
Generally, the symptoms will clear up as soon as the infection is gone. However, the effects can sometimes last longer.
You might still feel dizzy and off-balance even when the other symptoms caused by the infection have gone. This can be a sign that the balance organs were damaged. Your brain can usually learn to work with these changes, so your sense of balance should usually come back by itself. However, if youre struggling to cope or the problem persists, you should see an ENT specialist. The doctor can check for any underlying causes and may refer you for vestibular rehabilitation therapy to help you to recover your balance.
Inner ear infections can also have a longer term effect on your hearing. This is more likely if you had bacterial infection, so your doctor might recommend a hearing test to check on your ears after the infection.
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Watchful Waiting Makes Sense In Most Cases
In most children it’s best to wait for two to three days in order to see whether the symptoms improve on their own, and then decide whether to use . This can help avoid side effects. Painkillers will relieve the pain more quickly than antibiotics. If you take a “watchful waiting” approach, it’s a good idea to go to back to the doctor for a check-up.
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What Are Ototopical Antibiotics
Ototopical antibiotics are medications administered topically in the ear for treating middle ear infections. Ototopical antibiotics are usually the first-line treatment for recurrent bacterial ear infections, in the absence of systemic infection.
Ear infections are more common in children, and often clear up on their own. Most ear infections can be managed with warm compresses and pain management. Antibiotics are usually administered only for severe and persistent ear infections.
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.
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When To See Your Doctor
See your doctor if your child:
- Is six months of age or younger
- Has a high fever or bad earache
- Has an ear discharge that lasts more than 24 hours
- Continues to have fever or bad earache two days after they start treatment
- Still seems to have trouble hearing after six to eight weeks
- Seems to be getting worse or you are worried at any time.
How To Use Ear Drops
Prior to using ear drops, you should always read the instructions provided to you with your prescription. You can also speak to your pharmacist or doctor for advice on using them. The following instructions will help you use ear drops correctly.
- Lie down on a flat surface with a folded towel beneath your head and the affected ear facing the ceiling.
- Pull your earlobe up to straighten out the ear canal.
- Administer the appropriate number of drops into the ear.
- Push the ear flap gently to help ease the drops into the ear.
- Remain in this position for up to two minutes to ensure that the ear canal is fully coated with medicine.
- Have the child lie on the floor or bed with a towel beneath their head and their affected ear facing the ceiling.
- Hold their head still if they are squirming or fidgeting.
- Pull the earlobe out and down to straighten their ear canal..
- Administer the recommended number of drops
- Press on their ear flap or place a cotton ball gently into the ear and let it remain in position for several minutes to ensure that the medication coats the inside of their ear.
The process for infants is similar to children, but you can also cradle your infant while you administer the drops in an appropriate position that allows the medication to go into their ear properly.
Antibiotics Can Help In Some Children
Some children may benefit more from than others: These include children who are under two years old and have an infection in both ears, and those of all age groups who are leaking pus from their ear. Both symptoms are signs of a bacterial infection, which can be treated effectively with antibiotics.
After three to seven days, out of children under two years of age with acute middle ear infection in both ears
- 55 out of 100 children who did not take still had an earache or fever, and
- 30 out of 100 children who used still did.
So the worked in 25 out of 100 of these children.
They also helped children who had fluid leaking from their ears.
- 60 out of 100 children who did not take still had fever or an earache,
- but only 24 out of 100 who used did.
So helped in 36 out of 100 children who had fluid leaking from their ears.
What Causes A Middle
The middle ear connects to the throat by a canal called the eustachiantube. This tube helps even out the pressure between the outer ear and theinner ear. A cold or allergy can irritate the tube or cause the area aroundit to swell. This can keep fluid from draining from the middle ear. Thefluid builds up behind the eardrum. Bacteria and viruses can grow in thisfluid. The bacteria and viruses cause the middle-ear infection.
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What Are The Disadvantages Of Ototopical Antibiotics
Ototopical antibiotics have a few disadvantages as well, which include the following:
Difficulty in delivery
Direct delivery at the infection site may be difficult or impossible sometimes. The medication may fail to reach the infected area in the middle ear if the ear canal is blocked due to:
- Excessive and hardened earwax
- Block in the ear tubes inserted for fluid drainage from the middle ear
- Swollen or overgrown tissue
Steps must be first taken to clear the blocks before antibiotic administration. Irrigating the ear canal can easily clear a block caused by earwax and other secretions, but an ear tube block and granulation each may require some procedure and other medications.
Ototoxicity is toxicity to the ear from local administration. Ototoxicity can irritate and inflame the mucus membranes of the middle ear. If the antibiotic enters the inner ear, it may lead to:
- Sensitivity reaction
Ototopical antibiotics can cause allergic reactions. Low-grade sensitivity reactions may cause persistent drainage that may be impossible to distinguish from drainage due to infection, making treatment difficult. Some people may also develop cross-sensitivity to related antibiotics.
Absence of systemic effect
Alteration of microenvironment
Fluid Buildup And Hearing Problems
Fluid behind the eardrum after an ear infection is normal. And in most children, the fluid clears up within 3 months without treatment. If your child has fluid buildup without infection, you may try watchful waiting.
Have your child’s hearing tested if the fluid lasts longer than 3 months. If hearing is normal, you may choose to keep watching your child without treatment.
If a child has fluid behind the eardrum for more than 3 months and has significant hearing problems, then treatment is needed. Sometimes short-term hearing loss occurs, which is especially a concern in children ages 2 and younger. Normal hearing is very important when young children are learning to talk.
If your child is younger than 2, your doctor may not wait 3 months to start treatment. Hearing problems at this age could affect your child’s speaking ability. This is also why children in this age group are closely watched when they have ear infections.
If there is a hearing problem, your doctor may also prescribe antibiotics to keep the fluid in the ear from getting infected. The doctor might also suggest placing tubes in the ears to drain the fluid and improve hearing.
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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.
What Are The Harms Of Fluid Buildup In Your Ears Or Repeated Or Ongoing Ear Infections
Most ear infections dont cause long-term problems, but when they do happen, complications can include:
- Loss of hearing: Some mild, temporary hearing loss usually occurs during an ear infection. Ongoing infections, infections that repeatedly occur, damage to internal structures in the ear from a buildup of fluid can cause more significant hearing loss.
- Delayed speech and language development: Children need to hear to learn language and develop speech. Muffled hearing for any length of time or loss of hearing can significantly delay or hamper development.
- Tear in the eardrum: A tear can develop in the eardrum from pressure from the long-lasting presence of fluid in the middle ear. About 5% to 10% of children with an ear infection develop a small tear in their eardrum. If the tear doesnt heal on its own, surgery may be needed. If you have drainage/discharge from your ear, do not place anything into your ear canal. Doing so can be dangerous if there is an accident with the item touching the ear drum.
- Spread of the infection: Infection that doesnt go away on its own, is untreated or is not fully resolved with treatment may spread beyond the ear. Infection can damage the nearby mastoid bone . On rare occasions, infection can spread to the membranes surrounding the brain and spinal cord and cause meningitis.
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When Should I See A Doctor
A mild ear infection may go away on its own. But most cases of moderate to severe ear pain require a visit to your doctor. You should also see your doctor if youre experiencing ear discharge, fever, or chills.
Children with ear infections may constantly cry due to pain and discomfort. They might also tug or pull at the affected ear. See your doctor if symptoms dont improve within , or if they get worse.
Other signs that you should see a pediatrician include:
- fever of 102.2°F or higher
Differences Between Middle Ear Infection And Outer Ear Infection
|Middle ear infection
|Outer ear infection
|Middle ear infection Usually affects children
|Outer ear infection Usually affects adults aged 45 to 75
|Middle ear infection Caused by viruses like colds and flu
|Outer ear infection Caused by something irritating the ear canal, such as eczema, water or wearing ear plugs
|Middle ear infection Affects the middle ear
|Outer ear infection Affects the ear canal
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What Is The Treatment For Ear Infections
Medications used to treat ear infections include:
- Pseudoephedrine to ease ear pressure
- Antibiotic ear drops for infections of the ear canal
- Polymyxin B
- Steroid ear drops for infections of the ear canal
- Oral antibiotics for infections of the middle ear , and severe infections of the outer ear
For mild cases of ear infection, doctors often recommend watching and waiting before starting use of antibiotics, as many cases will go away on their own. Consult your childs pediatrician before giving any over-the-counter medications to your child.
Home remedies to relieve symptoms include:
- Warm compresses applied to the area to help soothe pain
- Over-the-counter pain eardrops
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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Are There Any Over
Over-the-counter oral antibiotics are not approved in the U.S. A bacterial infection is best treated with a prescription antibiotic that is specific for the type of bacteria causing the infection. Using a specific antibiotic will increase the chances that the infection is cured and help to prevent antibiotic resistance. In addition, a lab culture may need to be performed to pinpoint the bacteria and to help select the best antibiotic. Taking the wrong antibiotic — or not enough — may worsen the infection and prevent the antibiotic from working the next time.
There are a few over-the-counter topical antibiotics that can be used on the skin. Some products treat or prevent minor cuts, scrapes or burns on the skin that may get infected with bacteria. These are available in creams, ointments, and even sprays.
Side Effects Of Antibiotics
It’s important to also consider possible side effects when looking at the benefits of . Antibiotics can cause nausea, diarrhea and rashes. Around 5 out of 100 children who use antibiotics had one of these side effects. Using antibiotics too often also leads to the development and spread of that no longer respond to antibiotics .
Who Should Use Antibiotic Eardrops
Antibiotic eardrops can be more effective and safer for:
- People with Swimmers Ear, an infection caused by water in the ear.
- Children who have tubes in their ears. The tubes prevent most infections behind the eardruman area known as the middle ear. If there is an infection, antibiotic eardrops can be given right through the tube.
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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Where Is The Middle Ear
The middle ear is behind the eardrum and is also home to the delicate bones that aid in hearing. These bones are the hammer , anvil and stirrup . To provide the bigger picture, lets look at the whole structure and function of the ear:
The ear structure and function
There are three main parts of the ear: outer, middle and inner.
- The outer ear is the outside external ear flap and the ear canal .
- The middle ear is the air-filled space between the eardrum and the inner ear. The middle ear houses the delicate bones that transmit sound vibrations from the eardrum to the inner ear. This is where ear infections occur.
- The inner ear contains the snail-shaped labyrinth that converts sound vibrations received from the middle ear to electrical signals. The auditory nerve carries these signals to the brain.
Other nearby parts
- The eustachian tube regulates air pressure within the middle ear, connecting it to the upper part of the throat.
- Adenoids are small pads of tissue above the throat and behind the nose and near the eustachian tubes. Adenoids help fight infection caused by bacteria that enters through the mouth.
Preventing Recurring Ear Infections
To help prevent any infection, a healthy body including a healthy gut is optimal. If breastfeeding is possible, it is one of the best preventative options, since it helps line the gut with beneficial bacteria. Introducing formula in the first six months of life is associated with more ear infections in early childhood . For kids of all ages, feeding them other prebiotics and probiotics, first in very small doses, will also improve gut health over time.
Another way to boost health is removing toxins from the childs diet, including processed foods, refined grains and sugars, industrial seed oils, and pesticide residues. If these recommendations sound familiar, it is because they are some of the first steps toward a Paleo diet and lifestyle, which can have a profound impact on overall well-being. Often children with food allergies are more susceptible to ear infections , perhaps because the immune system is already overly activated and cannot properly fight additional infections. Removing common allergens such as gluten, soy, dairy, and peanuts from the childs diet also may help.
Xylitol, a sugar alcohol, in a nasal spray can help ward off infections of the ear, nose, and throat . This compound acts to break down the tough buildup of bacteria, called biofilm, that can stagnate in the nasal passageways. If you have a patient prone to chronic ear infections, a regimen of xylitol nasal spray, such as Xlear Nasal Spray, is worth exploring .
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