The goal of treatment for most doctors is to rid the middle ear of infection before more serious complications set in. Treatment usually involves eliminating the causes of the ear infection, killing any invading bacteria, boosting the immune system, and reducing swelling in the eustachian tubes.
Conventional Medicine for Ear Infections
An ear infection is often caused by a virus, in which case the only relief doctors can offer is treatment of the symptoms. If a person has an upper respiratory infection causing a lot of congestion and swelling of membranes (including the eustachian tube), medicines which dry up the congestion may be helpful. However, if there is only an ear infection without congestion or drainage, decongestants and antihistamines are not helpful and should not be used to avoid possible side effects (drowsiness, jitteriness, blurred vision).
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To ease the pain of an ear infection, your doctor may recommend a pain reliever, typically acetaminophen or ibuprofen, which also helps reduce a fever. Aspirin should be avoided in children because of the threat of Reye's syndrome. Sometimes it is difficult for your doctor to tell if the ear infection is of viral or bacterial origin.
A controversy surrounds the use of antibiotics in treating bacterial middle ear infections. This debate arose in the 1990’s as more bacteria became resistant to antibiotics. Some doctors initially treat only the symptoms of an ear infection, without the help of bacteria-killing drugs. Support for this type of treatment originates from studies on children aged 2 and older.
But many doctors, particularly in the U.S., are concerned that without antibiotics, bacteria lurking inside the middle ear can grow out of control, possibly causing a serious complication such as hearing loss or mastoiditis. After all, they point out, these complications have become rare, largely as a result of antibiotic therapy. To be on the safe side, many American doctors treat all ear infections as if bacteria were present.
Amoxicillin is the antibiotic of choice for treating bacterial ear infections. The drug is highly effective: A single course of amoxicillin can usually knock out an ear infection in seven to 10 days, at little cost.
Lately, however, doctors have noticed trouble with this wonder drug. As it turns out, some types of bacteria have grown resistant to amoxicillin. Critics of routine antibiotic use in the U.S. charge that the millions of prescriptions of amoxicillin written for ear infections that had no bacterial element helped to create these resistant bacterial strains.
Whatever their origin, amoxicillin-resistant bacteria have shown up in a number of communities, prompting many doctors to prescribe other antibiotics for ear infections. Some of these substitutes, which tend to be more expensive than amoxicillin, are taken from a class of medications called cephalosporins. Others are combination drugs - amoxicillin and clavulanate, for instance. For those allergic to amoxicillin, doctors may prescribe sulfamethoxazole and trimethoprim, or erythromycin mixed with a sulfa drug like sulfisoxazole.
If an ear infection causes serious complications or if fluid remains in the ear for more than three months, physicians may suggest myringotomy with PE (pressure equalizing) tube insertion surgery to eliminate infection or drain the middle ear. Because not enough air is coming through the eustachian tube to ventilate and dry out the middle ear, a little tube, less than half an inch long, is placed into the ear drum. The tube, which will usually fall out on its own in about a year, keeps a hole open in the eardrum so that air can get into the middle ear space and dry it out. A ventilation tube reduces pain, improves hearing, and cuts down on the amount of infections your child may have.
This procedure rarely leads to infection or scarring and usually provides long lasting positive results. If after tubes come out the ear infections return, it means your child hasn’t outgrown the problem and a second set of tubes will usually be recommended. This time, an adenoidectomy -- surgery to remove the adenoids -- will also be suggested in an attempt to unblock the eustachian tubes as much as possible, and to prevent a third set of tubes.
Tonsillectomy is generally not considered helpful for recurrent ear infections and is not usually recommended.
Home Remedies for Ear Infections
You can provide a great deal of ear infection symptom relief at home. Try these tips
*Many find that warmth, perhaps from a warm compress, brings comfort. Steam inhalations may also help, but take care not to burn yourself; protect your eye area as well.
*Taking antihistamines may dry out your throat and respiratory passages and are to be avoided unless there’s also congestion. Sip water frequently.
*If you bottle feed your baby make sure the baby is held in a relatively upright position. Never put your baby to bed with a bottle and try to take your baby off of the bottle as soon as your child's physician feels the child is ready.
*In older children or adults, gargling with salt water helps soothe an aggravated throat and clear the eustachian tubes.
*Holding your head erect can help drain your middle ear.
*Any smokers should refrain from smoking inside the house or anywhere around your child.
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