Ear Infection

another nightmare for Geeks With Kids

often known as Otitis Media (which is specifically a middle ear infection)

Feb'2011: latest studies - A study with an appropriate design was needed to resolve the controversy regarding antimicrobial therapy versus observation in children with certain diagnoses of acute otitis media. The investigators in both Pittsburgh and Turku have provided such a study. They performed randomized, blinded trials of the use of amoxicillin–clavulanate (not amoxicillin alone) as compared with Placebo in the age group at greatest risk. The acute otitis media in the children who were enrolled in the studies was defined by the acute onset of the condition and the presence of middle-ear effusion, a bulging tympanic membrane, and otalgia or erythema of the tympanic membrane. In these two studies, acute otitis media was meticulously assessed by experienced otoscopists, and only children with a clear, certain diagnosis of acute otitis media were enrolled. The results of each study showed a significant benefit among children who received the drug with respect to the duration of acute signs of illness. Even earlier studies stressed that AOM must be distinguished from otitis media with effusion (OME). OME is more common, occurs with the common cold, can be a precursor or a consequence of AOM, and is not an indication for antibiotic treatment.

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This notes There are different forms of otitis media. Typically, when the doctor refers to an ear infection, he or she is most likely talking about "acute otitis media"... Acute otitis media is the presence of fluid, typically pus, in the middle ear with symptoms of pain, redness of the eardrum, and possible fever. Other forms of otitis media are either more Chronic in nature (meaning that there's fluid in the middle ear for 6 or more weeks) or there's fluid in the middle ear that's temporary and isn't necessarily infected (this is called otitis media with effusion). The reason that doctors try to distinguish between the different forms of otitis is because it affects treatment options. Not all forms of otitis need to be treated with antibiotics... The fact that most ear infections can clear on their own has led a number of physician associations to recommend a "wait-and-see" approach, which involves giving the child pain relief without antibiotics for a few days.

Also note that Antibiotic resistance occurs most frequently in patients with recently treated acute otitis media, children who attend Day-Care facilities and children younger than two years of age... At present, we do not have clinical criteria for distinguishing which children are in need of antibiotic therapy for acute otitis media. (from 2000)

The AAFP says The best treatment is to let the fluid go away by itself... If the fluid is still there after a few months and is causing hearing loss or problems in both ears, antibiotics may help some children... Giving your child unnecessary Antibiotics can be harmful. After each course of antibiotics, the germs in the nose and throat are more likely to become resistant. Resistant germs can't be killed by the usual antibiotics.

• actually, that's for when it's still "with effusion". If bacteria grow in the middle ear fluid, an effusion can become a middle ear infection (acute otitis). This will usually increase pressure behind the eardrum and cause a lot of pain. The eardrum will become red and bulging. If this happens, your child may need to be treated with antibiotics.

It's not infectious (though the cold associated with it is, of course).

Can increase risk of Sinus Infection.