Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
Around 75 percent of children will have at least one ear infection before they reach 3 years old. Ear infections are the most common reason that children visit doctors. Ear infections are also known as glue ear, secretory otitis media, middle ear infection, or serous otitis media.
* Ear infections are more common in young boys than young girls.
* Most ear infections improve without treatment.
* Vaccinating a child against the flu can help prevent ear infections.
* Biofilms of antibiotic-resistant bacteria may be to blame for prolonged and repeated cases of ear infection.
* Secondhand smoke increases the risk of ear infections.
Ear infections are very common and affect 5 out of 6 children in their first 3 years.
An ear infection is a bacterial or viral infection of the middle ear. This infection causes inflammation and the buildup of fluid within the internal spaces of the ear. Ear infections are painful because the inflammation and buildup of excess fluid increases pressure on the eardrum. An ear infection can be acute or chronic. Chronic ear infections may permanently damage the middle ear.
In adults, the symptoms are simple. Adults with ear infections experience ear pain and pressure, fluid in the ear, and reduced hearing. Children experience a wider range of signs. These include:
* Tugging or pulling at the ear
* Ear pain, especially when lying down.
* Difficulty sleeping
* Crying more than normal
* Loss of balance
* Difficulty hearing
* Lack of appetite
Ear infections are generally divided into three categories.
* Acute otitis media (AOM)
AOM is the most common and least serious form of ear infection. The middle ear becomes infected and swollen, and fluid is trapped behind the eardrum. Fever can also occur.
* Otitis media with effusion (OME)
After an ear infection has run its course, there may be some fluid left behind in the eardrum. A person with OME may not experience symptoms, but a doctor will be able to spot the remaining fluid.
* Chronic otitis media with effusion (COME)
COME refers to fluid repeatedly returning to the middle ear, with or without an infection present. This leads to a reduced ability to fight other infections and hurts hearing ability.
TESTS AND DIAGNOSES
There are several ways to diagnose ear infections. Doctors will typically use a device called an otoscope. Testing for ear infection is a relatively simple procedure and a diagnosis can often be made based on symptoms alone.
* The doctor will generally use an otoscope, an instrument with a light attachment, to check for fluid behind the eardrum.
* They may sometimes use a pneumatic otoscope to test for infection. This device checks for trapped fluid by releasing a puff of air into the ear. Any fluid behind the eardrum will cause the eardrum to move less than normal.
* If in doubt, the doctor may use other methods to confirm a middle ear infection.
* Ear infections will often clear up without treatment, and the only medication necessary is pain management. Antibiotics are only used in more severe or prolonged cases.
* Infants under 6 months of age need antibiotic treatment to help prevent the spread of bacterial infection. Amoxicillin is often the antibiotic of choice.
* For children aged 6 months to 2 years, physicians typically recommend monitoring the child without antibiotics, unless the child has signs of a severe infection.
The American Academy of Family Physicians (AAFP) recommend watchful waiting for:
* Children aged 6 to 23 months who have experienced mild inner ear pain in one ear for less than 48 hours and a temperature of less than 102.2° Fahrenheit (39° Celsius)
* Children aged 24 months and over with mild inner ear pain in one or both ears for less than 48 hours and a temperature of less than 102.2°F
* For children older than 2 years, antibiotics are not normally prescribed. Overuse of antibiotics leads to antibiotic resistance. This can mean that serious infections become more difficult to treat.
* The AAFP recommends pain management medicine for persistent infections, including acetaminophen, ibuprofen, or eardrops. These help with fever and discomfort.
* A warm compress, such as a towel, may soothe the affected ear.
Ear infections are extremely common, especially among children. This is due to an immature immune system and differences in the anatomy of the ear. There is no guaranteed way to prevent infection, but there are several recommendations that will reduce the risk:
* Vaccinated children are less likely to get ear infections.
* Wash hands and the child’s hands often. This prevents the potential spreading of bacteria to your child and can help prevent them from catching colds and flu.
* Avoid exposing a child to second-hand smoke. Infants who spend time around people who are smoking are more likely to get ear infections.
* Breastfeed infants where possible. This helps enhance their immunity.
* When bottle-feeding an infant, feed them sitting up to reduce the risk of milk flowing into the middle ear. Do not let a baby suck on a bottle while they are lying down.
* Avoid letting your child play with sick children and try to minimize their exposure to group care or large groups of children.
* Do not use antibiotics unless necessary. Ear infections are more likely in children who have had an ear infection within the previous 3 months, especially if they were treated with antibiotics.
* Ear infections are a part of most people’s childhood. They can be painful and debilitating, but they present very few long-term problems if properly managed.