Download Ears and Tears and Infections…Oh MY!!!! Middle Ear Infection Guide

Ears and Tears and Infections…Oh MY!!!!
Middle Ear Infection Guide
Erase the Ache of Ear Infections
What is a middle ear infection?
A middle ear infection, also known as acute otitis media, is an infection or swelling of the middle
ear and is most common in children between the ages of three months and three years.
What causes middle ear infections?
When a child has a cold or a nose or throat infection, the tube connecting the middle ear to the
back of the throat, called the Eustachian tube, can become blocked, causing build-up of fluid in
the middle ear. When the fluid trapped in the middle ear becomes infected by bacteria, a middle
ear infection can develop. The three most common bacteria that cause middle ear infections
are called Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis.
Is there a time of year when ear infections are more prevalent?
Yes, ear infections are more prevalent in late fall, winter and spring. However, children can
develop middle ear infections during any time of year. Common risk factors such as age (being
younger than 2), heredity, exposure to cigarette smoke and breastfeeding (which lowers a
child’s risk) are independent of the calendar. However, colds and allergies are also risk factors
for infection, so your child will develop an ear infection more often during cold and flu season.
What are the signs and symptoms of middle ear infections?
Symptoms of middle ear infection include ear pain, fever and difficulty hearing. Young children
express these symptoms through ear tugging, irritability, loss of appetite, waking at night and
persistent crying. Doctors diagnose the infection based on these signs and symptoms as well
as by the appearance of the eardrum when they look inside the child’s ear.
What are some ways to prevent middle ear infections?
Middle ear infections spread through the passage of bacteria. While some infections are
unavoidable, the spread of bacteria can be reduced by teaching children to wash their hands
frequently, cover their mouths when they cough and to not share drinking cups. Parents can
modify their behavior to help reduce illness by not smoking, wiping toys clean that children
share and breastfeeding, if possible.
Antibiotic-resistant middle ear infections are also a problem. Parents can assist in reducing
these tough-to-treat infections by ensuring that antibiotics are taken correctly:
• Be methodical with medicine: the entire prescription should be taken, despite children feeling
better after a few days, and doses should be given at the same times every day
• Antibiotics should not be “saved” for future use
• Antibiotics should not be expected or requested for viral illnesses, such as cold and flu
What is antibiotic resistance?
Antibiotic resistance occurs when the bacteria that cause infection are not all killed by
antibiotics. The remaining bacteria become stronger and may resist future antibiotic treatments.
Resistance also increases when antibiotics are given for viral illnesses, such as colds or flu, or
when prescriptions are not taken to completion. Antibiotic resistance is a problem because
these types of illnesses are tougher to treat. It is important to use antibiotics correctly and
appropriately to ensure their future effectiveness.
What is the best treatment for my child’s middle ear infection?
Middle ear infections can be effectively treated with antibiotics. The Centers for Disease Control
and Prevention (CDC) published treatment recommendations to assist pediatricians in
identifying which medications work best in a variety of situations. The CDC recommends
amoxicillin as initial therapy for children with middle ear infections. However, in children who
have received an antibiotic within the last three months of their current infection, who are two
years of age or younger or who attend child care, high dose amoxicillin/clavulanate is
recommended as first-line treatment. This is the dose found in the antibiotic
Augmentin ES-600. Other recommended antibiotics include high dose amoxicillin or Ceftin®
(cefuroxime axetil). Parents should ask their pediatrician about these recommendations.
What are the potential medical complications from middle ear infections?
Frequent and/or long-lasting middle ear infections may affect a child’s hearing during a time that
is critical for speech and language development. An unsuccessfully treated middle ear infection
can also lead to a ruptured eardrum. Other rare, but potentially serious, complications from
improperly treated middle ear infections include mastoiditis (an infection of the bone behind the
ear), meningitis (an infection of the membranes surrounding the brain and spinal cord), brain
abscesses and permanent hearing loss.
When can my child return to child care after being diagnosed with an ear infection?
In most states, licensed child care facilities are mandated to isolate all children with fevers and
send them home. Because the children are not allowed to return to group care for at least 24
hours after the fever subsides, there is often an urgency to seek a quick return to wellness
through the use of antibiotic therapy. Unfortunately, this misuse of antibiotics (as some fevers
are not related to bacterial infections) could actually contribute to increasing antibiotic
resistance. Parents should check with their child care facility regarding the policy for sick
children.
Other Facts about Middle Ear Infections:
Middle ear infections are one of the most common childhood infections, causing
more doctor visits than any other condition.
Middle ear infections cause more than 30 million doctor visits each year.
Three out of four young children will experience an ear infection before the age of
three and, of these, half will experience repeat episodes of infection.
Middle ear infections are more common among children in child care due to their
close contact with other children. An estimated three out of five young children
(infants and toddlers) are in child care.
Provided by the National Association of Child Care Professionals (NACCP).