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All About Earaches And When Antibiotics Are Needed To Treat Them

All About Earaches And When Antibiotics Are Needed To Treat Them

For such a small part of the body, ears have a powerful impact. Raise your hand if you’ve spent a long night with a toddler who wakes up suddenly with an earache, and his pain kept him, and you, and other family members up for most of the rest of the night.

Earaches often start suddenly, but they’re also masters of surprise. Many children develop colds, sneeze their way through a week of symptoms, and then seem to be on the mend. Until a fever develops late in the week, and an ear starts to hurt right about the time you were starting to think the worst had passed.

Adding to the mischief, it’s impossible to take a quick peak at your child’s ear the way you can look at her rash, or her throat when she’s crying. Usually, once you know that earache isn’t going to go away with the first dose of ibuprofen, you have to pack up and head to your pediatrician/family doctor/nurse practitioner to find out exactly what’s going on.

There are actually many things that may show up when you look in a child’s ear. A bulging red ear drum. Drainage from tubes. A ruptured ear drum. Swimmer’s ear. Dry wax. Lego. And my personal favourite, from early in my career… a live cockroach! (Really. But that’s a story for another post)

Pain in the ear is a very common complaint in a pediatric office at this time of year. By the time a child arrives for assessment, most parents have taken the best first steps to help reduce acute pain — usually a dose of ibuprofen or acetaminophen.

So here’s the good news: Any medical problem that is as common as the earache has been well studied. When the cause is Lego, we’ll take it out. When the cause is infection, here are the current antibiotic treatment guidelines of the American Academy of Pediatrics.

When should antibiotics be prescribed?

  • For children age 6 months and younger – for AOM (acute ear infections.)
  • Children age 6 months to 2 years – for AOM with severe symptoms; observation (48-72 hours) is an option for AOM if it’s non-severe.
  • Children age 2 to 12 years – antibiotic treatment for AOM with severe symptoms; observation (48-72 hours) is an option for a non-severe AOM.

As always, prevention is better than treatment. Avoid bottle propping (when you prop baby’s bottle up so he can feed without you having to hold it). Also avoid bottles in bed. Protect your children from second hand smoke. Practice good hygiene and increased attention to handwashing, cleaning toys, countertops, tables and other surfaces.

Do the best you can, and remember your child thrives in the security and care you provide when they are sick, as much as the play and fun you have together when they are well.

 

– Dr. G Paul Dempsey

[Featured image: Robbie Grubbs]

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