Ear Infections

Otitis Media

There are two common types of ear infections, Otitis Media and Otitis Externa (Swimmer's Ear)

First, we will review middle ear infections.

Middle ear infections are incredibly common, most children will suffer at least one episode by the time they are 3.

Symptoms - Fever and ear pain

Causes - Bacteria and Virus (majority)

Treatment - Even in cases where Otitis Media is caused by bacteria, they seldom need antibiotics. In fact, 80% of children will resolve the infection on their own within 48 hours without antibiotics. The most recent literature shows that 1/20 (95%) of children receiving antibiotics derive no benefit, and 1/8 may actually suffer harms (nausea, vomiting, stomach upset, rash, allergic reaction). For this reason, most physicians will not prescribe antibiotics right away, as long as a "watch and wait" strategy is appropriate.

When to see a Doctor

- Fever persisting > 48 hours

- Swelling or redness behind the ear

- Fever not responding to acetaminophen or ibuprofen

- Child under the age of 6 months, or immunocompromised

- If you have any concerns your child is seriously ill

- If your child has recurrent episodes of Otitis Media

- If your child's ear begins to drain fluid

Otitis Externa (Swimmer's Ear)

Swimmer's ear is an infection of the ear canal. It commonly occurs after swimming, where a wet ear canal has allowed bacteria to proliferate. Otitis Externa isn't only caused from swimming, any form of trauma to the ear canal can cause an infection (ie: cotton-tip swabs, finger in ear, ear buds etc...)

Symptoms - Ear pain, pain with pulling on the ear lobe, itchiness inside the ear, discharge from the ear canal, redness and swelling

Prevention - Dry ears after swimming or bathing (pat dry with a towel, avoid cotton-tip swabs).

Treatment - antibiotic ear drops. Occasionally, oral antibiotics are required

When to see a Doctor

- When the ear becomes painful as above, antibiotics are generally required to clear the infection