Acute Otitis Media (Middle Ear Infections) – Part II


Part II – here ya go!

At what point do I start worrying that my child may need an antibiotic to treat their ear infection?

Some guidelines have been set-up to help decide whether antibiotic therapy should be used or not.

According to these guidelines, antibiotics are recommended for use in children less than 2 years of age and in children older than 2 where both letters are infected or where there is discharge from the affected ear.

Children older than 2 years who have mild symptoms of AOM and only one infected ear can take the "watchful waiting" approach.

With the "watchful waiting" option, you would observe your child's condition for 48 to 72 hours, and if the signs or symptoms of AOM worsen or persist, you would follow-up with your child's physician.

At this point, the physician would most likely start your child on a course of antibiotics. The "watchful waiting" option is not appropriate in those cases where follow-up can not be ensured or where parents or caretakers do not understand the risks and benefits of this kind of approach.

I know what you're probably thinking; there is no way you're going to take the chance with this watchful waiting deal. But just think, one less medication means fewer medication side effects and an opportunity to avoid being involved with the antibiotic resistance saga.

You know your child the best; you will be able to tell if they are not getting better. You can do it – I have faith in you!

Continuing on …

Signs and symptoms of middle ear infections appear so quickly you will not even see them coming!

The obvious signs of AOM are ear pain, fever, and hearing loss. Be on the lookout for your infant pulling on their ear; it's a good way to tell if their ear is bothering them since they can not share this with you in words quite yet.

Also, do not panic with the hearing loss idea, it's happening because of the fluid build-up in the eustachian tubes and it is a temporary problem .

There are times when the signs and symptoms of a middle ear infection will be less obvious, especially in young children. These not so obvious symptoms include fatigue, irritability, loss of appetite, or vomiting, and they usually occur more often in children who have been suffering from an upper respiratory tract infection for several days. Ugh, two infections in one, that's a double whammy right there!

Also, be aware that it is possible for your child to not have any signs or symptoms of AOM other than a fever, in which case it's important that their ears still get examined.

Regardless of whether antibiotics are used or not (check out Part I of this ear infection series, and do not forget about Part II and Part III!), Symptoms caused by the ear infection can be treated. Some good options to treat ear pain are Tylenol, Motrin, and Auralgan, all of which have a generic available.

Auralgan is an eardrop that contains a combination of antipyrine, benzocaine, and glycerin and is available by prescription only. The benefits of using Tylenol and Motrin are they can be purchased over-the-counter and they help treat a fever too.

I would NOT , I repeat, I would NOT use antihistamines (like Benadryl) and / or decongestants (like Sudafed) because they have not been shown to be effective in treating AOM and they only lead to more medication side effects.

It's GI Joe time; the true American hero is calling my name … going to the movies and the rose gardens here in Portland! No worries – I'm still here for discussion, questions, and comments. Get at me at !