Thursday, April 18, 2024

What Antibiotics Help With Ear Infections

How Do Antibiotics Work Against Ear Infections

Medical Myth: Ear Infections Require Antibiotics

Ear infections typically occur when fluid becomes built up behind the eardrum, causing pain and inflammation. Since most ear infections are caused by bacteria growth, they are often treated with antibiotics.

However, this is not the case for every ear infection some factors that can affect treatment options and outcomes include the cause of the infection, the severity, the location and your age. In addition, recurrent ear infections often require a different approach altogether.

If you have an ear infection, below is information that can help you understand a doctors recommendation.

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

Causes Of Ear Infections

Ear infections are oftentimes byproducts of upper respiratory infections, especially those caused by bacteria. The bacteria known as

Hemophilus influenza and Streptococcus pneumoniae are the most common culprits. Its often the case that as you recover from a viral respiratory illness, bacteria can travel to the middle ear and become trapped, leading to a secondary infection in the ears.

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Middle Ear Infection: Will Antibiotics Help Relieve Symptoms In Babies And Toddlers

Middle ear infections will usually clear up within a few days, with or without treatment. But can speed up recovery in children under two years of age who have an infection in both ears. They may also help if the infected ears are leaking fluid.

Middle ear infections can cause earache and fever. These symptoms can be treated with painkillers like acetaminophen or ibuprofen. Whether are an appropriate treatment will depend on what other symptoms the child has. Antibiotics can only help treat bacterial infections. Children with specific symptoms benefit from them, but antibiotics will hardly help in children without these symptoms.

Research on for acute middle ear infections

Researchers from the , an international network of researchers, looked for studies that could help show the advantages and disadvantages of antibiotic treatment of acute middle ear infections in babies and toddlers. They found 13 reliable studies involving a total of about 3,400 children. The studies randomly divided the children into two groups and then compared them with each other. One group of children took and the other did not.

The researchers wanted to know what effect had on pain and fever after one to seven days of treatment. They were also interested in whether children who took antibiotics had fewer complications like hearing problems, or the spread of the infection to the other ear or the bone behind the ear. The possible side effects were also investigated.

Antibiotics are often ineffective

Cold And Allergy Remedies

What is the best antibiotic for an ear infection?

Recent research has questioned the general safety of cough and cold products for children. They are currently banned for use in children under age 4 years. The American College of Chest Physicians recommends against the use of nonprescription cough and cold medicines in children age 14 years and younger.

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Diagnosis Of Ear Infections

Your physician will look into your ear with an otoscope, a medical instrument with a light on one end designed to get a better view inside the ear. Your doctor will look for the visual signs of ear infection, such as redness and inflammation.

To check for fluid buildup, a pneumatic otoscope, which blows air at the eardrum, will be used. If there is excessive fluid behind the eardrum, it will not move as it should when the air hits it.

In some cases, hearing tests may also be performed to assess any damage to the ear from the infection.

Different types of ear infections present with different symptoms, which can include:

  • Inner ear infections: Hearing loss, ringing in the ears , dizziness, loss of balance, nausea and vomiting, and ear pain
  • Middle ear infections: Fluid in the ear, ear pain, fever, a feeling of general illness, pressure in the ears, and hearing loss
  • Outer ear infections: Inflammation of the ear canal, itching in the ear, ear pain, swelling of the ear canal, redness, and fluid draining from the ear

Ear Infection Doctor Discussion Guide

Children with ear infections, especially toddlers or infants, may not be able to describe their symptoms, but an ear infection will often present with the following signs:

  • Tugging or pulling at their ears
  • Fussing or crying
  • Being clumsy and having balance issues
  • Trouble hearing or responding to quiet noises

How To Take Clindamycin

Use Clindamycin exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Clindamycin oral is taken by mouth. Clindamycin injection is injected into a muscle, or as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.

Take the capsule with a full glass of water to keep it from irritating your throat.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device .

You may need frequent medical tests during treatment.

If you need surgery, tell your surgeon you currently use clindamycin.

Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Clindamycin will not treat a viral infection such as the flu or a common cold.

Store at room temperature away from moisture and heat. Protect the injectable medicine from high heat.

Do not store the oral liquid in the refrigerator. Throw away any unused oral liquid after 2 weeks.

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

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What If My Ear Infection Doesnt Go Away After Antibiotics

If you or your child finish your course of antibiotics, but it seems like the ear infection hasnt gone away, make an appointment with your doctor. Theyll help figure out whats going on and what to do next. Theres a chance that your doctor may prescribe a different type of antibiotic to see if it works better.

Its also possible that the infection is gone but the symptoms arent. This can happen if theres still fluid trapped in the ear, causing a plugged-up feeling, pain or hearing loss. Most of the time the fluid in ears drains within a couple of weeks, but sometimes it sticks around longer.

Can Middle Ear Infections Be Prevented

Antibiotic Ear Drops – When and How to Use Ear Drops Properly

It’s not possible to prevent middle ear infections, but there are some things you can do that may reduce your child’s risk of developing the condition. These include:

  • make sure your child is up-to-date with their routine vaccinations particularly the pneumococcal vaccine and the DTaP/IPV/Hib vaccine
  • avoid exposing your child to smoky environments
  • don’t give your child a dummy once they’re older than six to 12 months old
  • don’t feed your child while they’re lying flat on their back
  • if possible, feed your baby with breast milk rather than formula milk

Avoiding contact with other children who are unwell may also help reduce your child’s chances of catching an infection that could lead to a middle ear infection.

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Perichondritis: Not Just Simple Cellulitis

Background: Perichondritis is an infection of the connective tissue of the ear that covers the cartilaginous auricle or pinna, excluding the lobule . The term perichondritis is itself a misnomer, as the cartilage is almost always involved, with abscess formation and cavitation . Perichondritis can be a devastating disease, and if left improperly treated, the infection can worsen into a liquefying chondritis resulting in disfigurement and/or loss of the external ear . Unfortunately, misdiagnosis and mistreatment is common. In one small retrospective review, the overwhelming majority of patients presenting to a large general hospital were prescribed antibiotics without appropriate antimicrobial coverage, resulting in a significant number of patients developing chondral deformities or cauliflower ear .

Ear Piercing Infection Effects

If the infection is in the acute early stages, catching it right away can help stop the situation from becoming chronic. Seek medical advice if you were recently diagnosed with an acute ear infection, but the treatment advised by your doctor has been ineffective, or your symptoms are increasing. If you are exhibiting signs of a recurring infection, you need to get in to see the doctor at once.

These regimen of antibiotics shall soon eradicate the infection. Antibiotic ear drops may also help to reduce any pain you experience. For severe, chronic diseases, the doctor may advise surgery if you do not experience any improvement after receiving treatment or your hearing is being affected. For children who have their ears pierces on their younger years, particularly hearing problems can cause speech and language impediments during a formative period, so the issue must be dealt with summarily.

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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 Causes An Ear Infection

choice of antibiotic for ear infection infographic

An ear infection usually is caused by bacteria and often begins after a child has a sore throat, cold, or other upper respiratory infection. If the upper respiratory infection is bacterial, these same bacteria may spread to the middle ear if the upper respiratory infection is caused by a virus, such as a cold, bacteria may be drawn to the microbe-friendly environment and move into the middle ear as a secondary infection. Because of the infection, fluid builds up behind the eardrum.

The ear has three major parts: the outer ear, the middle ear, and the inner ear. The outer ear, also called the pinna, includes everything we see on the outsidethe curved flap of the ear leading down to the earlobebut it also includes the ear canal, which begins at the opening to the ear and extends to the eardrum. The eardrum is a membrane that separates the outer ear from the middle ear.

The middle earwhich is where ear infections occuris located between the eardrum and the inner ear. Within the middle ear are three tiny bones called the malleus, incus, and stapes that transmit sound vibrations from the eardrum to the inner ear. The bones of the middle ear are surrounded by air.

The inner ear contains the labyrinth, which help us keep our balance. The cochlea, a part of the labyrinth, is a snail-shaped organ that converts sound vibrations from the middle ear into electrical signals. The auditory nerve carries these signals from the cochlea to the brain.

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What Are The Advantages Of Ototopical Antibiotics

Administration of antibiotics directly in the ear has several advantages over systemic delivery including the following:

Antibiotic concentration

Topical antibiotic solutions contain vastly greater concentration of antibiotic than the medications administered orally, or even intravenously. The high antibiotic concentration, delivered directly at the site of the infection, is much more effective in killing the bacteria. It also reduces the possibility for development of antibiotic-resistant bacterial strains.

The lowest level of drug concentration that can prevent bacterial growth is known as minimum inhibitory concentration . Some drug-resistant bacteria have a high MIC, but ototopical antibiotics far exceed the MIC required for destroying even highly resistant bacteria.

Absence of systemic effects

The absence of systemic effects with topical administration eliminates the risk of systemic antibiotic side effects. The normal beneficial bacteria that live in the respiratory and gastrointestinal tracts are unaffected. Absence of systemic antibiotics also prevents the natural selection and proliferation of drug-resistant bacteria.

Alteration of microenvironment

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When Should I Call The Doctor

Very rarely, ear infections that don’t go away or severe repeated middle ear infections can lead to complications. So kids with an earache or a sense of fullness in the ear, especially when combined with fever, should be seen by their doctors if they aren’t getting better after a couple of days.

Other things can cause earaches, such as teething, a foreign object in the ear, or hard earwax. Your doctor can find the cause of your child’s discomfort and treat it.

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How Are Ear Infections Treated

Most ear infections go away on their own. You can treat them at home with an over-the-counter pain reliever like acetaminophen , a warm face cloth on the ear, and rest. Your doctor may give you eardrops that can help with pain.

Do not give aspirin to anyone younger than 18.

Your doctor may prescribe antibiotics. Antibiotics are recommended for children under 6 months old and for children at high risk for complications. But ear infections often get better without them. Talk with your doctor. Whether you use antibiotics will depend on how bad the infection is. For children, it also will depend on the child’s age.

Children may need a follow-up visit in about 4 weeks, even if they feel well. Adults may need one if symptoms get worse.

Minor surgery to put tubes in the ears may help for repeat infections or hearing problems.

When To Seek Medical Advice

Antibiotic Awareness: Ear Infection or Acute Otitis Media

Most cases of otitis media pass within a few days, so there’s usually no need to see your GP.

However, see your GP if you or your child have:

  • symptoms showing no sign of improvement after two or three days
  • a lot of pain
  • a discharge of pus or fluid from the ear some people develop a persistent and painless ear discharge that lasts for many months, known as chronic suppurative otitis media
  • an underlying health condition, such as cystic fibrosis or congenital heart disease, which could make complications more likely

Read more about diagnosing middle ear infections

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Antibiotics Come With Serious Long

The limited benefit of antibiotics for ear infection must be weighed against the risks. Among children treated with antibiotics, one in 14 had symptoms such as diarrhea, vomiting, and rash. However, the effect of antibiotic use on long-term health is even more serious.

This widespread bacterial death can have detrimental effects. It is hard to overstate the importance of the beneficial bacteria that live in the human body and make up a healthy microbiome. A rapidly growing body of evidence shows that resident bacteria affect diverse systems in the body and are essential components of long-term health.

We already know gut bacteria play a role in:

  • Immune regulation
  • Inflammation
  • And more

Unfortunately, there is evidence that a persons microbiome may never fully recover from antibiotic use. Lasting reduction in beneficial bacteria may increase our susceptibility to deadly pathogens like C. difficile and may play a role in the dramatic rise of conditions like obesity, type 1 diabetes, inflammatory bowel disease, allergies, and asthma.

Children are especially susceptible to these potential dangers. As one example, a single course of amoxicillin or a macrolide antibioticmost commonly used to treat pediatric ear infectionsmay eradicate H. pylori in 20 to 50 percent of cases. Unfortunately, the loss of this protective bacteria in children is associated with greater likelihood of developing asthma, hay fever, or skin allergies.

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