Many physicians recommend the use of an antibiotic (a drug that kills bacteria) when there is an activemiddle ear infection. If a child is experiencing pain, the physician may also recommend a pain reliever.Following the physician's instructions is very important. Once started, the antibiotic should be taken untilit is finished. Most physicians will have the child return for a followup examination to see if the infectionhas cleared. Unfortunately, there are many bacteria that can cause otitis media, and some have becomeresistant to some antibiotics. This happens when antibiotics are given for coughs, colds, flu, or viralinfections where antibiotic treatment is not useful. When bacteria become resistant to antibiotics, thosetreatments are then less effective against infections. This means that several different antibiotics may(over)have to be tried before an ear infection clears. Antibiotics may also produce unwanted side effects such asnausea, diarrhea, and rashes.**
Full Answer
Is there an optimal timing for follow-up of acute otitis media after treatment?
Objective: Because the optimal timing for follow-up of acute otitis media (AOM) is unknown and clinicians' recommendations for timing follow-up are highly variable, a study was conducted to determine which risk factors or symptoms could predict the resolution, recurrence, or persistence of AOM after treatment completion.
Are antibiotics necessary for acute otitis media?
This article has been cited byother articles in PMC. Otitis media is the most common childhood infection for which antibiotics are prescribed. Nonetheless, there are a number of important questions about the optimal management of acute otitis media (AOM), and opinion is divided within the medical community on a range of fundamental issues.
What happens when the otitis media does not drain properly?
When this tube is not working properly, it prevents normal drainage of fluid from the middle ear, causing a build up of fluid behind the eardrum. When this fluid cannot drain, it allows for the growth of bacteria and viruses in the ear that can lead to acute otitis media.
What is the pathophysiology of acute otitis media?
Acute otitis media is usually a complication of eustachian tube dysfunction that occurs during a viral upper respiratory tract infection. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common organisms isolated from middle ear fluid. Management of acute otitis media should begin with adequate analgesia.
When should I follow up after otitis media?
Most cases of otitis media are self-limited. If the signs and symptoms of acute otitis media (AOM) are resolved, patients should follow up with their primary care provider (PCP) in 4-6 weeks to evaluate for persistent OME.
When should you recheck an ear infection?
It is very important to have the ears rechecked because symptoms of persistent ear infection or "fluid" may not be obvious and may lead to hearing loss or difficulties with language or school. Your child's doctor will advise you when to schedule your recheck appointment (usually two to four weeks).
What is the most common complication of otitis media?
Meningitis is the most common intracranial complication of the acute otitis media [3]. Vigorous pain, fever, vomiting, photophobia, seizures can be seen. The findings of Kernig and Brudzinski can be followed.
How do physicians treat otitis media?
Antibiotic Selection. High-dosage amoxicillin (80 to 90 mg per kg per day, divided into two daily doses for 10 days) is recommended as first-line antibiotic therapy in children with acute otitis media. In children older than six years with mild to moderate disease, a five- to seven-day course is adequate.
What is recheck exam?
A recheck examination is an appointment that allows your veterinarian to assess the progress and follow-up on your pet's disease or problem.
What happens if your ear infection won't go away with antibiotics?
Possible Complications A chronic ear infection may cause permanent changes to the ear and nearby bones, including: Infection of the mastoid bone behind the ear (mastoiditis) Ongoing drainage from a hole in the eardrum that does not heal, or after ear tubes are inserted.
What are the priorities of care for the person with otitis media?
The goal of nursing care to a child with otitis media include relief from pain, improved hearing and communication, avoidance of re-infection, and increased knowledge about the disease condition and its management.
What are the potential consequences of untreated otitis media?
Otitis media will often resolve without any treatment. However, possible complications of untreated otitis media include a hole (perforation) of the eardrum, hearing loss, and mastoiditis (see section below).
Which of the following treatments is appropriate for a patient who has acute otitis media and has an allergy to penicillin?
Patients who are allergic to penicillin show 10-15% cross-reactivity when treated with cephalosporins. Levofloxacin has demonstrated higher efficacy in the treatment of AOM than amoxicillin-clavulanate has and can be used in patients who are allergic to penicillin.
What is the prognosis for otitis media?
The prognosis of otitis media is usually good without treatment. Acute otitis media will usually resolve itself within 2 weeks. Otitis media with effusion will usually resolve itself within 3 months.
What are the five risk factors for otitis media?
The following are proven risk factors for otitis media:Prematurity and low birth weight.Young age.Early onset.Family history.Race - Native American, Inuit, Australian aborigine.Altered immunity.Craniofacial abnormalities.Neuromuscular disease.More items...•
How long does it take for antibiotics to work for otitis media?
Clinical improvement should be noticed within 48 to 72 hours of initiating antibiotics for AOM. Symptoms may worsen during the 24 hours after diagnosis of AOM. Decrease in initial symptoms such as fever, irritability, trouble sleeping etc. should start to occur within the following 48 hours.
What is the procedure for ear infections?
Procedures include inserting ear tubes or removing adenoids and , in rare cases, the tonsils.
How long does it take for fluid to clear up in the ear?
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.
What to do if your child has a cochlear implant?
If your child has cochlear implants, your doctor will probably prescribe antibiotics. That's because serious complications of ear infections, including bacterial meningitis, are more common in children who have cochlear implants than in children who don't have these implants. Follow-up exams with a doctor are important.
How long does it take for a child to have a follow up exam?
Even if your child seems well, he or she may need a follow-up visit in about 4 weeks , especially if your child is young.
How old do you have to be to take antibiotics?
But antibiotics are recommended for children under the age of 6 months and for children at high risk for complications. You can treat your child at home with an over-the-counter pain reliever like acetaminophen (such as Tylenol), a warm washcloth on the ear, and rest.
How long does it take for a child to have hearing loss?
Sometimes short-term hearing loss occurs. This 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.
Can antibiotics be used for ear infections?
Many doctors don't want to prescribe long-term antibiotics because they aren't sure that they really work.
What are the different types of otitis media?
Different types of otitis media include the following: Acute otitis media. This middle ear infection occurs abruptly causing swelling and redness. Fluid and mucus become trapped inside the ear, causing the child to have a fever and ear pain. Otitis media with effusion. Fluid (effusion) and mucus continue to accumulate in ...
What instrument is used to check the inner ear?
In addition to a complete medical history and physical examination, your child's health care provider will inspect the outer ear (s) and eardrum (s) using an otoscope. The otoscope is a lighted instrument that allows the health care provider to see inside the ear.
How do you know if you have otitis media?
Ear Infection Symptoms. The following are the most common symptoms of otitis media. However, each child may experience symptoms differently. Symptoms may include: Unusual irritability. Difficulty sleeping or staying asleep. Tugging or pulling at one or both ears. Fever, especially in infants and younger children.
What is pneumatic otoscope?
A pneumatic otoscope blows a puff of air into the ear to test eardrum movement. Tympanometry is a test that can be performed in most health care providers' offices to help determine how the middle ear is functioning.
What is the cause of ear infections?
Middle ear infections are usually a result of a malfunction of the eustachian tube, a canal that links the middle ear with the throat area. The eustachian tube helps to equalize the pressure between the outer ear and the middle ear.
Why is my eustachian tube not working?
The following are some of the reasons that the eustachian tube may not work properly: A cold or allergy which can lead to swelling and congestion of the lining of the nose, throat, and eustachian tube (this swelling prevents the normal drainage of fluids from the ear) A malformation of the eustachian tube.
What is the name of the inflammation in the middle of the ear?
Middle Ear Infection. Otitis media is inflammation or infection located in the middle ear. Otitis media can occur as a result of a cold, sore throat, or respiratory infection.
What is tympanocentesis considered for?
A tympanocentesis should be considered for both therapeutic (relief of pressure and pain) and for diagnostic (recovery of the etiologic agent) purposes. If a tympanocentesis is not practical, consideration should be given to adding amoxicillin-clavulanate or selecting one of the alternative agents from Table 1.
What is the most common childhood infection for which antibiotics are prescribed?
Otitis media is the most common childhood infection for which antibiotics are prescribed. Nonetheless, there are a number of important questions about the optimal management of acute otitis media (AOM), and opinion is divided within the medical community on a range of fundamental issues. The purpose of this statement is to address several ...
Is antimicrobial therapy necessary for AOM?
Antimicrobial therapy is one of the cornerstones in the management of AOM but some studies have suggested that its routine use is not indicated (2–4). Because the majority of cases of AOM resolve spontaneously (1), it might appear that antimicrobial therapy is not necessary.
Is penicillin more expensive than amoxicillin?
Furthermore, the newer, broader spectrum, penicillinase-stable antimicrobial agents are substantially more expensive than amoxicillin (Table 1), and their use may be associated with relatively high rates of side effects and may increase the pressure for selection of multiply antibiotic-resistant strains of bacteria.
Is parenteral therapy better than oral therapy?
There is, at present, little published evidence that parenteral therapy provides any advantage to the conventional 10-day oral therapy. Furthermore, the use of such broad-spectrum agents may hasten the emergence of antibiotic-resistant organisms.