Weekend house call: Treating ear infections


W TO TREAT IT. DR. COREY: SO MANY PEOPLE, ADULTS AND KIDS, ARE GETTING EAR INFECTIONS IN THE LAST MONTH. WITH THE ALLERGIES AND URIS, IT’S ALMOST INEVITABLE. ALSO KNOWN AS OTITIS MEDIA, THE SYMPTOMS ARE FEVER, EAR PAIN, AND A FEELING OF FULLNESS IN THE YEAR AS WELL AS FUSSINESS AND FEEDING PROBLEMS IN YOUNG CHILDREN. BOTTLE-FEEDING WHEN THE CHILD IS LYING FLAT ON HIS BACK INCREASES THE RISK OF EAR INFECTION IN BABIES AND EXPOSURE TO CIGARETTE SMOKE IS ALSO A RISK FACTOR. OTITIS CAN CAUSE TEMPORARY HEARING LOSS AND CAN BE CAUSED BY VIRUSES OR BACTERIA. ACUTE OTITIS MEDIA IS USUALLY OF RAPID ONSET AND SHORT DURATION AND CHRONIC OTITIS MEDIA IS A PERSISTENT INFLAMMATION OF THE MIDDLE EAR, TYPICALLY FOR A MINIMUM OF A MONTH. FOLLOWING AN ACUTE INFECTION, FLUID MAY REMAIN BEHIND THE EAR DRUM FOR UP TO THREE MONTHS BEFORE RESOLVING. SEVERE EAR INFECTIONS MAY CAUSE THE EARDRUM TO RUPTURE. YOUNG CHILDREN TEND TO HAVE EAR INFECTIONS MORE THAN ADULTS BECAUSE THE CANAL THAT RUNS FROM THE MIDDLE EAR TO THE BACK OF THE NOSE AND THROAT, CALLED THE EUSTACHIAN TUBE, IS SHORTER AND MORE HORIZONTAL IN YOUNG CHILDREN. BUT IF YOU ARE AN ADULT WHENEVER YOU HAVE INCREASED CONGESTION LIKE WHEN YOU HAVE A RUNNY NOSE FROM ALLERGIES THEN YOU CAN GET , AN EAR INFECTION. THERE IS NO DEFINITIVE LAB TEST FOR ACUTE OTITIS MEDIA AND THE TREATMENT VARIES DEPENDING UPON THE AGE OF THE PERSON AND THE SYMPTOMS. THERE ARE A FEW WAYS TO DEAL WITH EAR INFECTIONS. YOU CAN START ANTIBIOTIC TREATMENT OR YOU CAN JUST OBSERVE, WHICH IS BASED ON AGE AND SEVERITY OF ILLNESS. OBSERVATION IS AN APPROPRIATE OPTION ONLY WHEN FOLLOW-UP CAN BE ENSURED AND ANTIBIOTICS CAN BE STARTED IF SYMPTOMS PERSIST OR WORSEN. IF ANTIBIOTICS ARE INITIATED, AMOXICILLIN IS USUALLY RECOMMENDED AS THE FIRST LINE TREATMENT. THIS IS USUALLY PRESCRIBED FOR 10 DAYS. EVEN AFTER ANTIBIOTIC TREATMENT, 40% OF CHILDREN ARE LEFT WITH SOME FLUID IN THE MIDDLE EAR WHICH CAN CAUSE TEMPORARY MILD , HEARING LOSS LASTING FOR UP TO 3 TO 6 WEEKS AND THIS FLUID EVENTUALLY DISAPPEARS SPONTANEOUSLY. CEFTRIAXONE INJECTIONS ARE RECOMMENDED FOR PATIENTS THAT CANNOT TAKE ORAL ANTIBIOTICS AND IF WHO HAVE RECURRING BOUTS OF OTITIS MEDIA SHOULD BE REFERRE TO AN OTOLARYNGOLOGIST. PATIENTS MAY BENEFIT FROM HAVING AN EAR TUBE SURGICALLY PLACED TO PERMIT FLUID TO DRAIN FROM THE MIDDLE EAR TO DECREASE THE NUMBER AND SEVERITY OF THE RECURRENT INFECTIONS. AND OH YEAH, THERE ARE NO PROVEN HOME TREATMENTS FOR ACUTE EAR INFECTION SO DON’T DELAY TREATMENT WHILE WAITING ON GRANDMA’S NEW REMEDY.

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