Ear Infection (cont.)
David Perlstein, MD, MBA, FAAP
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Otitis media (ear infection or inflammation) facts
- What is otitis media?
- What are the symptoms of acute middle ear infection?
- "Are ear infections contagious?
- How common is acute otitis media?
- Why do young children tend to have middle ear infections or inflammation?
- How does the Eustachian tube change as a child gets older?
- What microorganisms cause otitis media?
- What is the relationship between bottlefeeding and middle ear infection or inflammation?
- What are the risk factors for acute middle ear infection or inflammation?
- How is otitis media diagnosed?
- How is acute middle ear infection or inflammation treated?
- Are there any home remedies for acute ear infection (otitis media)?
- What causes chronic middle ear infection or inflammation?
- What happens to the eardrum in chronic middle ear infection or inflammation?
- What happens to the eardrum if a hole develops in the eardrum?
- How is chronic middle ear infection or inflammation treated?
- What are the goals of otitis media surgery?
- What is serious middle ear infection or inflammation?
- What limitations are there on a child with middle ear infection or inflammation?
- Can otitis media (middle ear infection or inflammation) be prevented?
- Ear Infection (Otitis Media) FAQs
- Find a local Ear, Nose, & Throat Doctor in your town
How is acute middle ear infection or inflammation treated?
The treatment for acute otitis media varies depending upon the age and symptoms of the child. The American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) recommend the following:
| AAP and AAFP Recommendations |
||
| Age |
Certain Diagnosis |
Uncertain Diagnosis |
| <6 months |
Antibiotics |
Antibiotics |
| 6 months-2years |
Antibiotics |
Antibiotics if severe illness; *Observation without antibiotics option
if non-severe illness |
| ≥2 years | Antibiotics if severe illness; *Observation option if non-severe illness | *Observation option without antibiotics |
*Observation is an appropriate option only when follow-up can be ensured and antibacterial agents can be started if symptoms persist or worsen. Non-severe illness is represented by mild ear pain and fever <39 C (102.2 F) in the past 24 hours. Severe illness is moderate to severe otalgia (ear pain) or fever 39 C.
If antibiotics are initiated, amoxicillin is usually recommended as the first line treatment. This is usually prescribed for 10 days. About 10% of children do not respond within the first 48-72 hours of treatment, and antibiotic therapy may have to be changed. Even after antibiotic treatment, 40% of children are left with some fluid in the middle ear which can cause temporary hearing loss lasting for up to 3 to 6 weeks. In most children, this fluid eventually disappears spontaneously (on its own). Ceftriaxone (50mg/kg/d) injection is recommended for children that cannot take oral antibiotics; three days of this antibiotic is usually more effective than a single injection.
Children who have recurring bouts of otitis media may be referred to an otolaryngologist (ear nose and throat specialist or ENT). Some of these children may benefit from having an ear tube placed (tympanostomy tube) to permit fluid to drain from the middle ear. In addition, if a child has a bulging eardrum and is experiencing severe pain, a procedure to lance the eardrum (myringotomy) may be recommended to release the pus. The eardrum usually heals within a week.
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