When do you need antibiotics for an ear infection?

Photo of a woman holding her ear in pain

Ear infections are common in children and many parents are convinced they need antibiotics. But sometimes antibiotics aren’t the answer. Learn about ear infections from Rachel Johnson, MD.

Many parents know what it’s like when their child experiences an ear infection. It’s painful for them and causes many sleepless nights for anyone. Here’s why it’s best to treat:

What Causes Ear Infections?

Rachel Johnson, MD, Department of Internal Medicine and Pediatrics at Nebraska Medicine, explains that an ear infection begins when fluid containing bacteria and viruses gets trapped in the ear. increase. The area becomes a breeding ground for bacteria.

“Our sinuses are like a big tube system that connects to our ears and mouth,” says Dr. Johnson. “When the sinuses are inflamed, the area shrinks, mucus is produced, and fluid backs up into the ear canal. Fluid and mucus lead to infection.”

Ear infections can cause not only fever and severe ear pain, but also dizziness, yellowish discharge, trouble sleeping, loss of balance, headaches, redness, and even hearing loss or more serious changes. There is a possibility

Why are some children more prone to ear infections than others?

Chronic or recurrent ear infections can occur in children and infants. Although rare, recurrent ear infections can occur in adults. But what could be causing it?

“In some people, the anatomy and angle of the ear canal is not as slanted, making it easier for mucus and fluid to clog,” Dr. Johnson explains. “Smoke exposure is also a major risk factor. Ear infections are common in children exposed to smoke in the home or caregiver environment.

Allergies can also play a role in ear infections, she says. Allergy symptoms can cause sinuses and ear tubes to become inflamed and trap bacteria. However, there are ways to help prevent ear infections.

“Breastfed children have a lower risk of ear infections. The antibodies in breast milk help reduce infections through natural immunity.”

Frequent hand washing and avoiding secondhand smoke are other ways to reduce the risk of developing ear infections. increase.

Why are some ear infection symptoms worse at night?

The increased pressure at night can worsen the symptoms of an ear infection. When lying down, the drainage of the middle ear may flow backwards, causing pressure and pain.

“This makes sense because of gravity and lying down,” explains Dr. Johnson. “All bodily fluids can be pooled in a sitting position. The ears should be in a negative pressure environment, so a lot of pressure will cause pain.”

When does a patient need an eustachian tube and what do they do?

Ear tubes are small plastic or metal tubes that are inserted into the ear to reduce ear infections by draining fluid and refreshing the air in the ear. Children who have recurring ear infections (three or more in six months or four or more in a year) or who are deaf may need a tube to inflate the middle ear. Ear infections are generally less common in adults, but sometimes a tube is needed.

“There are certainly adults who need tubes. We have several adult patients who need tubes because they have recurrent ear infections as adults,” says Dr. Johnson. “It’s rare, but it happens.”

When do you need antibiotics for ear infections?

Not all ear infections need to be treated with antibiotics. In fact, according to Dr. Johnson, about a quarter of ear infections are viral, so antibiotics won’t help.

“If a child under the age of 2 has an ear infection, we treat it with antibiotics. Ear infections in adults are so rare that most adults need antibiotics. Antibiotics are also recommended for children and adults with severe symptoms, high fever, or both ear infections,” she says.

Ear infections that don’t require antibiotics go away on their own, especially in children over the age of two. This usually means they are viral, so parents can wait to see if the symptoms subside.

Who can treat ear infections in children and adults?

Parents or adults can contact their primary care physician or pediatrician if they notice symptoms of a potential ear infection or schedule an on-demand video visit to watch virtually.

“Ideally, it would be best to have the ear examined to confirm that it is an ear infection, but doing a virtual visit is also very reasonable,” says Dr. Johnson. “If a patient has ear pain, high fever or other viral symptoms, we can do a virtual visit. We need to know the exact number of infections.”

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