Treatment and Prevention
Otitis media is often treated with antibiotics. To lower the chances of the infection returning, it's very important to take the antibiotics regularly and finish the entire course of treatment even if the symptoms improve quickly. Many of the infections are actually triggered by viruses and, in some cases, a short period of watchful waiting rather than antibiotics may be appropriate for children who neither have recurrent infections nor visible structural changes in their ears. Over 80% of ear infections improve naturally on their own without antibiotic treatment and with no complications.
Antihistamines may help people who have allergies and ear infections. But no medications other than antibiotics will cure the ear infection if it's caused by bacteria. Pain relievers such as acetaminophen* or ibuprofen can be used to ease the pain of the infection and to lower a child's fever. Holding warm cloths over the sore ear may also provide some relief, as will putting drops of slightly warm olive oil into the ear canal once a doctor has viewed the eardrum and made sure there is no perforation. Prescription ear drops to relieve the pain are also available - ask your doctor.
Young children cannot "pop" open their ears to equalize ear pressures like older children and adults because their eustachian tubes are straight. As the head grows, the tube starts to curve downward into a more angled adult configuration, beginning at about age 3.5 years. This explains why ear infections naturally decrease dramatically by age 4. It also means that starting at this age, children (like adults) can chew sugar-free gum (e.g., when going up or down in an airplane) to help "pop open" their ears, allowing air to enter and fluid to drain, reducing ear discomfort and the chance of developing an infection.
Fluid buildup in the middle ear can be drained surgically. In a procedure called a myringotomy, a tiny opening in the eardrum is made so that fluid drains away or can be suctioned out. This procedure also allows air to reach the middle ear, hich equalizes the pressure and facilitates drainage down the eustachian tube. The cause of fluid accumulation must also be treated. For instance, if allergic reactions are to blame for blocking the eustachian tube, then antihistamines can be given to relieve allergies.
If there is chronic infection or fluid buildup behind the eardrum, and especially if there is a documented loss of hearing, a small tube may be inserted into the opening made by myringotomy. Called PE ("pressure equalization") tubes, these devices allow air to enter the ear and any fluid to drain out. Most are designed to fall out within 6 months to 2 years. In the rare case where symptoms occur again, the PE tubes can be replaced.
If the child has a permanent hole in his or her eardrum that's causing chronic otitis media, the eardrum itself may be repaired by a procedure called a tympanoplasty.
It's hard to prevent ear infections since many children, especially those who attend daycare, are susceptible to colds. Careful hand-washing regimens can help reduce the chance of catching colds, so it's important to remind your kids to wash up as often as possible.
Breast-feeding seems to lower the chances of developing ear infections among infants and children by helping to boost their immunity. Another good preventative measure is to keep your home smoke free as smoking increases the risk of middle ear infections. Immunization with the pneumococcal and influenza vaccines can lessen the likelihood of getting ear infections caused by these bacteria.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
John Goldenring, MD, MPH, JD, Pediatrics, Sharp Rees-Stealy Medical Group, San Diego, CA. Review provided by VeriMed Healthcare Network.