With this condition, the middle ear becomes infected and inflamed. The middle ear is located behind the eardrum.
This condition is caused by bacteria and viruses, such as:
These factors increase your chance of developing middle ear infection:
Tell your doctor if you have any of these risk factors.
Symptoms include:
The doctor will ask about symptoms and medical history, and perform a physical exam. Most middle ear infections can be diagnosed by looking into the ear with a lighted instrument, called an otoscope.
The doctor will see if there is fluid or pus behind the eardrum. A small tube and bulb may be attached to the otoscope. This is to blow a light puff of air into the ear. The puff helps the doctor see if the eardrum is moving normally.
Other tests may include:
Treatments include:
Antibiotics are commonly used to treat ear infections. Examples include:
Other medications sometimes used include:
Since bacteria develop a resistance to antibiotics, doctors may take a "wait and see" approach. In some cases, your doctor may prescribe an antibiotic for your child and ask you to use the medication if the pain or fever lasts for a certain number of days. This approach has been effective. *
Some ear infections are caused by a virus. This type will not go away faster with antibiotics. Most middle ear infections (including bacterial ones) tend to improve on their own in 2-3 days.
Pain relievers can help reduce pain, fever, and irritability. These include:
Decongestants and antihistamines are not recommended to treat an ear infection. *²
Ear drops may help decrease pain. If there is a chance that the eardrum has ruptured, do not use ear drops.
Myringotomy is surgery done to open the eardrum. A tiny cut is made in the eardrum to drain fluid and pus.
If you are diagnosed with an ear infection, follow your doctor's instructions .
To reduce the chance of getting an ear infection:
RESOURCES:
American Academy of Otolaryngology, Head and Neck Surgery
http://www.entnet.org
National Institute on Deafness and Other Communication Disorders
http://www.nidcd.nih.gov
CANADIAN RESOURCES:
Caring for Kids
http://www.caringforkids.cps.ca/
Health Canada
http://www.hc-sc.gc.ca/index_e.html
References:
Acute otitis media. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 2008. Accessed July 28, 2008.
Behrmann R, Kliegman R, Jenson HB. Nelson Textbook of Pediatrics . 16th ed. Philadelphia, PA: WB Saunders; 2000.
Griffith HW. Griffith's 5-Minute Clinical Consult . Baltimore, MD: Williams & Wilkins; 1999.
Hurst DS, Amin K, Seveus L, Venge P. Evidence of mast cell activity in the middle ears of children with otitis media with effusion. Laryngoscope . 1999;109:471-477.
Otitis media (ear infection). National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/ . Published July 2003. Accessed July 29, 2008.
Phillips. Otitis media, milk allergy, and folk medicine. Pediatrics .1972;50:346.
*10/12/06 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Spiro DM, Tay KY, Arnold DH, Dziura JD, Baker MD, Shapiro ED. Wait-and-see prescription for the treatment of acute otitis media: a randomized controlled trial. JAMA . 2006;296:1235-1241.
*9/23/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Coleman C, Moore M. Decongestants and antihistamines for acute otitis media in children. Cochrane Database of Systematic Reviews. 2008(3). CD001727. DOI: 10.1002/14651858.CD001727.pub4.
Last reviewed November 2008 by Elie Edmond Rebeiz, MD, FACS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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