Download Middle Ear Infections - North Scottsdale Pediatrics

North Scottsdale Pediatrics
Middle Ear Infections (Otitis Media)
Acute otitis media means inflammation of the middle ear. After the common cold, ear
infections are the most often diagnosed childhood illness in the US. Most children will have
had at least one ear infection by the time they are 3 years old and ¼ of this children will have
repeated ear infections. In 5-10% of children, the pressure in the middle ear causes the
eardrum to rupture creating a small hole in the drum for infected fluid to drain. When properly
treated by your healthcare provider, permanent damage to the ear or hearing is very rare.
Symptoms:
Fluid, typically pus, in the middle ear can present with pain, redness and bulging of the
eardrum. Other symptoms include fever, irritability, difficulty hearing and poor sleep. Other
forms of otitis media are either more chronic (fluid in the middle ear for 6 weeks or more) or
the fluid in the middle ear is temporary and not necessarily infected (otitis media with
effusion). Your healthcare provider will distinguish between the different types of infection to
determine the best treatment option. Not all forms of otitis need to be treated with antibiotics.
Treatment:
Middle ear infections often self- resolve in a few days without any specific treatment. A “waitand-see” approach, giving the child pain relief (ibuprofen or acetaminophen) without an
antibiotic may be recommended. If an antibiotic is prescribed, a 10 day course is usually
recommended. However for kids 6 years and older with mild to moderate infection, a
shortened course of 5-7 days may be all that is needed. Even after antibiotic treatment, fluid
may remain in the middle ear for up to several months, warranting close follow up. Kids with
persistent fluid in the middle ear (lasting longer than 3 months) should be rechecked every 3
months to ensure resolution. For children with recurrent ear infections or persistent fluid in
the middle ear, an ENT (ear, nose and throat specialist) consultation for placement of
ventilation tubes in the eardrum may be recommended.
Contagiousness:
Middle ear infections are not contagious, though the cold that may lead to one can be. Your
child can return to school when he or she is feeling better and fever-free. Swimming is okay as
long as there is no perforation in the eardrum or drainage from the ear. Air travel is also safe
Ear Infections
1
while on antibiotics with extra measures to ensure comfort, including ibuprofen, chewing gum,
sucking on a pacifier, swallowing fluids to assist with pressure changes during takeoff and
landing.
Prevention:
1. Breastfeed infants for at least 6 months to pass on maternal antibodies in breast milk to
reduce the rate of ear infections. If a child is bottle- fed, never feed in the horizontal
position or bottle-prop which can contribute to eustachian tube dysfunction
2. Prevent exposure to second hand smoke, which can increase the frequency and severity of
ear infections
3. Reduce exposure, as best as possible, to large groups of kids (large daycare centers)
because multiple upper respiratory infections may lead to frequent ear infections
4. Good hand washing for all caregivers and kids to decrease person-to –person transmission
of germs that cause colds and therefore ear infections
5. Vaccinate because certain vaccines can help prevent ear infections
When to call?
Although rare, ear infections that don’t go away or severe repeated middle ear infections can
lead to complications like spread to nearby bones. Call immediately if your child develops a stiff
neck, fever, acts very sick or lethargic with an earache or a sense of fullness in the ear.
Ear Infections
2