Why Does My Baby Need More Antibiotics for an Ear Infection

Ear infections are the well-nigh mutual bacterial infection in kids, and one of the nearly common reasons for a pediatrician to prescribe antibiotics. Given what we now know about how the overuse of antibiotics may crusade bacteria to get resistant to them, however, it makes sense for doctors to exist less quick to prescribe them.

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That's why the American Academy of Pediatrics (AAP) issued guidelines in 2013 to help pediatricians and parents make smart decisions about when antibiotics are really necessary to treat ear infections. Then the adjacent time your baby starts yanking on her ear or your 5-year-erstwhile suddenly runs a fever, keep these guidelines in listen.

Diagnosis of Ear Infections

The first thing to know about ear infections is that it's not always clear a child really has one, fifty-fifty to a doctor. It seems it should be a straightforward thing to diagnose: You lot look within a child'due south ear and you can see if it's infected or not, right? But information technology tin can be tough to get a articulate view of the inside of a younger child'due south ear. And it'south easy to fault fluid in the ear for an infection, to characterization redness caused past fever or crying equally a sign of infection, or to not exist able to even encounter the eardrum because of ear wax.

One clue that a kid truly has an ear infection is that she's also had some of the classic symptoms: rapid onset of an earache (otalgia), pulling on the ear (something babies will do in response to ear pain), irritability, the drainage of fluid from the ear (otorrhea), and fever.

When Antibiotics Actually Are Needed

Co-ordinate to the AAP guidelines, all babies under 6 months who develop an ear infection should be treated with antibiotics. Kids between 6 months and ii years also should get antibiotics if their pediatrician is certain they have an ear infection. (Remember, it tin can be a deceptively tricky diagnosis to make.) A kid who has severe symptoms, such as extreme pain or a fever over 102.two F, too should be treated with antibiotics even if the doctor isn't 100 percent certain she has an ear infection.

Most children with certain chronic wellness bug also should be put on antibiotics for an ear infection. This includes kids with Downwardly syndrome, immune arrangement problems, crack palate, or a cochlear implant. The aforementioned holds truthful for any child who's had an ear infection in the previous 30 days or has chronic fluid in her ears.

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The Observation Option

Older kids and those who are salubrious in general unremarkably don't need antibiotics to clear upwardly an ear infection, at to the lowest degree non at showtime. For them, the AAP guidelines advise using an "observation option." This means but watching a child advisedly for the first 48 to 72 hours after she's diagnosed. If her symptoms get worse, or don't better at all, then it'south time to call in a prescription for antibiotics.

Pediatricians handle this scenario in different means. Some take parents come back to the office, others volition prescribe the medication over the telephone, and some doctors will write out a "just-in-instance" prescription for parents to have on hand.

This method of observation instead of prescribing antibiotics right away has been working successfully in other countries and has few risks. It works because virtually kids with ear infections will likely get improve on their ain anyhow. Kids aren't left to suffer, nonetheless: The guidelines recommend giving acetaminophen or ibuprofen for hurting relief.

When Expect-and-See Doesn't Work

If afterwards the ascertainment period a child's ear infection symptoms don't lessen and it's clear she needs an antibiotic to treat it, the AAP guidelines recommend starting with amoxicillin, and moving on to a stronger medication afterward 48 to 72 hours if amoxicillin doesn't relieve symptoms or a child's fever stays at 102.2 F or in a higher place.

After that, or equally an alternative if a kid is vomiting, she may need i or three days of an intravenous or intramuscular antibiotic, such equally Rocephin (ceftriaxone). For kids with certain allergies, the AAP guidelines list alternative antibiotics that will exist safe for them to accept.

Regardless of the specific antibody prescribed, co-ordinate to the AAP children under 6 and those with severe symptoms should stay on medication for a total 10 days. Older kids may do well with but five to seven days of antibiotics.

Preventing Ear Infections in the First Place

The AAP also recommends taking measures to reduce risk factors for ear infections, especially during infancy. These include breastfeeding for at least six months, never giving a baby a bottle while she's lying down, and weaning from a pacifier after vi months. And kids of all ages should exist kept abroad from second-hand smoke.

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Verywell Health uses but high-quality sources, including peer-reviewed studies, to back up the facts within our articles. Read our editorial procedure to learn more well-nigh how nosotros fact-check and keep our content accurate, reliable, and trustworthy.

1. InformedHealth.org [Internet]. Cologne, Deutschland: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Center ear infection: Overview. 2009 Jun 29 [Updated 2019 May 9].

2. Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and direction of astute otitis media. Pediatrics. 2013;131(3):e964-99. doi:10.1542/peds.2012-3488

3. National Constitute on Deafness and Other Communication Disorders. Ear Infections in Children.

Boosted Reading

• Lieberthal As, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013;131(3):e964-99. doi:10.1542/peds.2012-3488

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Source: https://www.verywellhealth.com/ear-infections-and-treatment-guidelines-for-kids-2632031

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