by Kimberly Allen RN
Ear infections are the most common reason for trips to the Dr’s office in the US with approximately 30 million visits every year. Nearly half of all prescriptions for antibiotics that are written for children are for ear infections. The estimates are that at least 75% of all children will have at least one ear infection before they are 3 years of age. The cost for treating ear infections is more than $2 billion a year in the US alone.
The medical term for ear infection is otitis media. It is an inflammation and/or infection of the middle ear. The middle ear is the very small space between the ear drum and the inner ear. Also in that small space is a tiny duct or tube called the eustachian tube that goes from the middle ear to the back of the throat. This tube is responsible for maintaining the same pressure inside your middle ear as the air pressure outside and also allows excess mucous to drain from your ear to your throat. In children, especially young children, the eustachian tubes are not only tiny but soft and weak as well as shorter and more horizontal than in adults and older children. Because of these factors bacteria and other microorganisms can easily get into the tubes causing infection.
Though ear infections are not contagious they do usually develop after a cold or other upper respiratory infection which are contagious. Ear infections can be caused by both bacteria and viruses, however, bacterial ear infections are far more common accounting for 85% of ear infections. There are a variety of different bacteria that can cause ear infections. Ear infections have been grouped into 3 different types; Acute Otitis Media (AOM), otitis media with effusion (OME), and otitis externa also known as swimmers ear. In AOM the infection causes pus to form in the middle ear causing increased pressure on the ear drum causing pain and symptoms of an acute infection. The bacteria most often responsible for AOM is the streptococcus pneumoniae which is responsible for a variety of upper respiratory and sinus infections. Of the viruses that can cause AOM the most common are the rhinoviruses and influenza viruses. Where as in OME fluid builds up in the middle ear but without the symptoms of acute infection. This type is more common than AOM and tends to be caused by viruses that lead to upper respiratory infections as well as allergies and usually does not improve with antibiotic therapy. It can also develop after being treated for AOM with antibiotics, sometimes there is residual fluid that stays in the middle ear causing difficulty with hearing and may take a month or more to resolve itself. Otitis externa or swimmers ear is an infection of the outer ear and/or outer canal. In otitis externa the outer ear usually becomes red and inflamed, it is also usually itchy and painful. This type of ear infection usually requires antibiotic therapy to resolve the infection.
Treatment of ear infections vary depending on the age of the child, the severity of symptoms and the type of infection it is. Most ear infections are treated with antibiotics and medications to relieve the pain. In older children Dr’s may opt to have the parents watch their child for a few days because many infections will resolve on their own and as children get older there are more things the Dr needs to consider before prescribing antibiotics. Children can become resistant leading to potentially more virile infections.
The best way to prevent ear infections is to try to prevent the infections that can lead to them. Hand washing can not be emphasized enough, especially during the “flu season”. Also carrying a small bottle of hand sanitizer and using it frequently can be helpful. Though immunizations don’t prevent ear infections they can prevent the illnesses that can lead to them. This would include regular flu vaccines and the pneumonia vaccine. Tale with your Dr about including these in your childs regular vaccination schedule.