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Dx Ear Infections Treatment: Read More


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Observation:
Anemia of Chronic Disease/ Inflammation

The Merck Manual Home Edition states:
"At about the age of 6 months, infants become more susceptible to infection because they lose protection from their mother's antibodies, which they received through the placenta before birth. Breastfeeding seems to partially protect children from ear infections because breast milk contains the mother's antibodies. Also at about this age, children become more sociable and may acquire viral infections after touching other children and objects, then putting their fingers in their mouth and nose. These infections may in turn lead to middle ear infections. Attendance at child care centers increases the risk of exposure to the common cold and hence to otitis media. Using a pacifier may impair the function of the eustachian tube and thus interfere with air reaching the middle ear. Middle ear infections can resolve relatively quickly (acute), or they can recur or persist over a long time (chronic)."

*Doctors use a handheld light called an otoscope to check the eardrum for redness or bulging.
*Acetaminophen or ibuprofen can relieve fever and pain, and antibiotics are usually used when children do not get better quickly or get worse.
*Acute middle ear infection (also called acute otitis media is most often caused by the same viruses that cause the common cold.
*An infection initially caused by a virus sometimes leads to a bacterial infection.

Symptoms
Infants with acute middle ear infections have a fever and trouble sleeping. They cry or become irritable for no reason. They may also have a runny nose, cough, vomiting, and diarrhea. The ear is painful and hearing may be decreased. Infants and children who cannot communicate verbally may pull at their ears. Older children are usually able to tell parents that their ear hurts or that they cannot hear well. Commonly, fluid accumulates behind the eardrum and remains after the acute infection has resolved. This disorder is called secretory otitis media. Complications: Rarely, acute middle ear infection leads to more serious complications. The eardrum may rupture, causing blood or fluid to drain from the ear. Also, nearby structures may become infected."

Medications Used in Treatment:
1. Macrolide Antibiotics: Zithromax®
2. Cephalosporin Antibiotics: Keflex®
3. Antifolate/Sulfa Antiobiotic Combinations: Bactrim DS®
4. Penicillin/Beta Lactamase Inhibitor Combination Antibiotic: Augmentin®
5. Cephalosporin: Cefdinir
6. Compounded Ciprofloxin .3% with dexamethasone .1%

Suggested Links:
*N.H.S. Choices
*Medscape

*[Editor] A compound combination of ciprofloxacin (antibiotic) and dexamethasone (anti-inflammatory) was described in Expert Opinion Pharmacotherapy 2013.


*[Editor] A new technique for chronic middle ear infections (otitis media) is balloon dilatation of the Eustachian tube that connects the middle ear to the pharyx (throat). The Journal of Clinical Otolaryngology 2013 stated "Balloon dilatation of the Eustachian tube appears to be safe, effective and affordable. Like many newly introduced techniques the evidence remains limited to non-controlled case-series, with heterogeneous data collection methods and lacking long-term outcomes. However, short-term data provides promising, consistent results based on objective measures, and when used selectively in patients refractive to maximal existing therapy, balloon dilatation presents a potentially significant advance".

[Editor]:External otitis (swimmer's ear) is prevented by putting drops of half rubbing alcohol and half with vinegar in the ear immediately after swimming except when perforation of the drum is suspected. After a physician' examination of the inner ear and ear drum, for itching, a corticosteroid ear drop is the first line of treatment: the doctor may add an antibiotic if he/she feels it is necessary. Wearing a shower cap and avoiding swimming re preventative measures. The white vinegar and rubbing alcohol should control yeast/fungal infections.

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