Middle Ear Infection
(Acute Otitis; Ear Infection, Middle; Otitis Media)
|The Middle Ear|
|Copyright © Nucleus Medical Media, Inc.|
- Streptococcus pneumoniae (most common)
- Haemophilus influenzae
- Moraxella (Branhamella) catarrhalis
- Streptococcus pyogenes (less common)
- Recent viral infection (eg, cold )
- Recent sinusitis
- Age: babies and toddlers
- Season: winter
- Attendance at day care
- Babies who are formula-fed
- Medical conditions that cause abnormalities of the eustachian tubes, such as:
- History of allergies (environmental allergies, food [milk] allergies )
- Gastroesophageal reflux disease (GERD)
- Babies whose mothers drank alcohol while pregnant
- Exposure to second hand smoke, usually cigarette smoke, but also from cooking and wood-heating
- Ear pain (babies may tug or rub at the ear or face)
- Hearing loss (may be only temporary, due to fluid accumulation)
- Decreased appetite, difficulty feeding
- Disturbed sleep
- Drainage from ear
- Difficulty with balance
- Tympanocentesis—used to drain fluid or pus from the middle ear using a needle, also used to check for bacteria
- Tympanometry—measures pressure in the middle ear and responsiveness of the eardrum, also used to check for fluid or pus
- Hearing test —may be done if you have had many ear infections
- Amoxicillin (Amoxil, Polymox)
- Clavulanate (Augmentin)
- Cephalosporins ( cefprozil , cefdinir , cefpodoxime , ceftriaxone )
- Sulfa drugs (eg, Septra, Bactrim, Pediazole)
Over-the-Counter Pain Relievers
- Note : Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.
- Avoid exposure to smoke.
- Breastfeed your baby for at least the first six months.
- Try to avoid giving your baby a pacifier.
- If you bottle-feed, keep your baby's head propped up as much as possible. Don't leave a bottle in the crib with your baby.
- Get tested for allergies.
- Treat related conditions, such as GERD.
- Practice good hand washing .
- Make sure your child's vaccinations are up to date. The pneumococcal vaccine can prevent middle ear infections.
- Consider getting a flu vaccine .
- If your child has a history of ear infections, talk to the doctor about long-term antibiotic use. This is used in some cases.
- Ask your doctor about tympanostomy tubes. These tubes help equalize pressure behind the eardrum.
- Xylitol is a natural sugar that is used as a sweetener in gum, candy, and other types of food. Eating food with xylitol on a regular basis may help to reduce your risk of ear infections.
American Academy of Otolaryngology, Head and Neck Surgery http://www.entnet.org/
National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/
Caring for Kids http://www.caringforkids.cps.ca/
Health Canada http://www.hc-sc.gc.ca/
Acute otitis media. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 2008. Accessed July 28, 2008.
Behrmann R, Kliegman R, Jenson HB. Nelson Textbook of Pediatrics . 16th ed. Philadelphia, PA: WB Saunders; 2000.
Griffith HW. Griffith's 5-Minute Clinical Consult . Baltimore, MD: Williams & Wilkins; 1999.
Hurst DS, Amin K, Seveus L, Venge P. Evidence of mast cell activity in the middle ears of children with otitis media with effusion. Laryngoscope . 1999;109:471-477.
Otitis media (ear infection). National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/ . Published July 2003. Accessed July 29, 2008.
Phillips BL. Otitis media, milk allergy, and folk medicine. Pediatrics .1972;50:346.
Side Effects. Antibiotics. Side Effects website. Available at: http://side-effects.org/antibiotics . Accessed November 30, 2010.
10/12/2006 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Spiro DM, Tay KY, Arnold DH, Dziura JD, Baker MD, Shapiro ED. Wait-and-see prescription for the treatment of acute otitis media: a randomized controlled trial. JAMA . 2006;296:1235-1241.
9/23/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Coleman C, Moore M. Decongestants and antihistamines for acute otitis media in children. Cochrane Database of Systematic Reviews. 2008(3). CD001727. DOI: 10.1002/14651858.CD001727.pub4.
6/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Foxlee R, Johansson A, Wejfalk J, Dawkins J, Dooley L, Del Mar C. Topical analgesia for acute otitis media. Cochrane Database Syst Rev. 2009;(2):CD005657.
7/21/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Pavia M, Bianco A, Nobile CG, Marinelli P, Angelillo IF. Efficacy of pneumococcal vaccination in children younger than 24 months: a meta-analysis. Pediatrics. 2009;123:e1103-1110.
11/30/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Coker TR, Chan LS, Newberry SJ, et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review. JAMA. 2010;304(19):2161-2169.
12/16/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Azarpazhooh A, Limeback H, Lawrence HP, Shah PS. Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database Syst Rev. 2011;11:CD007095.
- Reviewer: Kari Kassir, MD
- Review Date: 09/2012 -
- Update Date: 00/93/2012 -