But let's back up for a moment. If you or your child has an ear that's hurting, is it always OM? No. Some of the other common possibilities would include referred pain from a sore throat, TMJ (pain from the jaw joint), Q-tip overuse (I frequently preach a 1 minute sermon on this), eustachian tube dysfunction, neuralgia (nerve pain), and outer ear infection ("swimmer's ear, or otitis externa -- OE). Enough medical lingo, let's look at the last one on that list, the outer ear infection, or OE. OE usually starts from having water sitting in the outer ear canal for too long. Over time the canal becomes infected, usually drains some moist material, and is sore to push on. OE occurs more commonly in the summer with all the swimming that goes on, and it's treated with antibiotic ear drops.
Ins and outs of simple ear infections
2009-01-19 23:33"It felt like somebody had stuck an ice pick into my ear, and then they were wiggling it around." This was one person's description of a recent ear infection. A few years back, I had a middle ear infection (otitis media -- OM) as well. Mine wasn't as bad as the wiggling ice pick description, but it was painful enough to renew my sympathy for the legions of little ones we see with this common condition. And we see more during the winter months than any other time of year.
Now back to mean old otitis media (OM). In children, OM is the most common infection treated by antibiotics. In fact, antibiotic resistance has become a problem in many of the common bacteria that cause OM. So the question has been asked over the years, "Should antibiotics always be prescribed for OM?" For many years Europe has taken a "watch and wait" approach to OM, prescribing antibiotics only in the worst cases, or when the OM wasn't clearing on its own. A few years back the pediatric and the family practice academies adopted a similar recommendation. In a nutshell, the recommendation is to still treat children 6 months of age or younger with antibiotics. Likewise, the more severe cases in the 6-month to 2-year-old range should usually be treated. But in otherwise healthy children older than 2 years, the recommendation is to take a watch and wait approach. This approach involves using pain relievers, but only prescribing antibiotics if the symptoms aren't resolving after 48-72 hours.
What are the pros and cons of this approach? The pros are that we can avoid potential complications of antibiotics, and hopefully slow the development of bacteria that are resistant to our antibiotics. Unfortunately there are few new antibiotics being developed, while the bacteria are rapidly developing resistance to the ones we have.
And what are the cons of watching and waiting? One fear is that there will be more serious complications of OM if we don't treat it promptly -- including big deal complications like mastoiditis (infection of one of the bones of the skull), meningitis, and pneumonia. But there seems to be no increase in these complications in Europe over the many years that they have taken the watch and wait approach. Besides the concern about complications, these infections (sometimes, but not always) can just hurt like stink! Most parents don't want to hear that even though their child is sick, crying, has a fever and an ear that probably feels like there's an ice pick jammed in it, "we're just going to give some pain reliever and see how it does over the next 2 or 3 days" -- especially if an effective antibiotic could perhaps resolve the pain in 24 hours (best-case scenario).
All that to say, even the treatment of the "simple ear infection" has some complexities. You can see why it's not a great idea to just "phone in an antibiotic" for a child who is fussy and seems like they might have an ear infection. When all is said and done, treating these infected ears has to be sorted out on an individual basis. So if you've got that ice pick in the ear feeling, or even something a bit less intense, call your doc, let them look, talk it over, make a plan.
source :www.thedailytimes.com
We recomend you to use the Eardoc
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