Clinical Reference Systems: Pediatric Advisor 10.0
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DESCRIPTION

An ear infection is a bacterial infection of the middle ear (the space behind the eardrum). It usually is a complication of a cold, occurring after the cold blocks off the eustachian tube (the passage connecting the middle ear to the back of the throat). Your ear is painful because trapped, infected fluid puts pressure on the eardrum, causing it to bulge. Other symptoms are irritability and poor sleep.

In 5% to 10% of ear infections, the pressure in the middle ear causes the eardrum to rupture and drain a yellow or cloudy fluid. This small tear usually heals over the next week. Ear infections are uncommon after 10 years of age, but can occur in anyone.

If the following treatment is carried out you should be fine. Permanent damage to the ear or to the hearing is very rare.

HOME TREATMENT

1. Antibiotics

   You need the antibiotic prescribed by your physician. This medicine will kill the bacteria that are causing the ear infection.

   Try not to forget any of the doses. Even though you will feel better in a few days, take the antibiotic until it is completely gone. Finishing the medicine will keep the ear infection from flaring up again.

2. Pain relief

   Acetaminophen or ibuprofen can be used to help with the earache or fever over 102 degrees F (39 degrees C) for a few days until the antibiotic takes effect. These medications usually control the pain within 1 to 2 hours. Earaches tend to hurt more at bedtime.

   To help ease the pain, you can put an ice bag or ice wrapped in a wet washcloth over the ear. This may decrease the swelling and pressure inside. Some physicians recommend a heating pad instead. Remove the cold or heat in 20 minutes to prevent frostbite or a burn.

3. Restrictions

   You can go outside and don't need to cover your ears. Swimming is permitted as long as there is no perforation (tear) in the eardrum or drainage from the ear. Air travel or a trip to the mountains is safe; just swallow fluids or chew gum during descent. You can return to school when you are feeling better and the fever is gone. Ear infections are not contagious.

4. Ear recheck

   Your physician will schedule a return appointment in 2 to 3 weeks for you. At that visit, your eardrum will be looked at to be certain that the infection is cleared up and more treatment isn't needed. Your physician may also want to test your hearing. Follow-up exams are very important, particularly if the eardrum is perforated.

CALL YOUR PHYSICIAN IMMEDIATELY IF:

• You develop a stiff neck.
• You feel very sick.

CALL YOUR PHYSICIAN DURING OFFICE HOURS IF:

• The fever or pain is not gone after you have taken the antibiotic for 48 hours.
• You have other questions or concerns.