Sick Kids: Treatment Tips for Parents
Understanding Ear Infections: Diagnosis and Treatment
How Are Ear Infections Diagnosed?
If you or your child has an earache that is accompanied, in some instances but not always, by a stuffy or runny nose and a sore throat and fever, it is likely that the ear pain is due to an ear infection. Your doctor will most likely examine the eardrum with an instrument called an otoscope for signs of infection -- not an easy task if the patient is a fussy infant. The doctor may also check for blockage or filling of the middle ear using a pneumatic otoscope, which blows a little air at the eardrum. This air should cause the eardrum to move a little back and forth. If fluid is present, the eardrum will not move as easily.
Another test for ear infections is tympanometry, which uses sound and air pressure to check for fluid in the middle ear. If needed, an audiologist will perform a hearing test to determine if there is hearing loss.
On rare occasions, when the person is quite ill, a doctor may make an opening in the eardrum, draw out a sample of fluid from the middle ear to culture the sample in a lab. This more extreme measure is usually used only for serious or particularly stubborn infections.
What Are the Treatments for Ear Infections?
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 tube.
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 tubes), 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 because of possible side effects (drowsiness, jitteriness, blurred vision).
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 with an otoscope alone if the ear infection is of viral or bacterial origin, so deciding on a proper course of treatment isn't always easy. A debate over using antibiotics (bacterial-killing drugs) to treat middle ear infections arose in the 1990’s as more bacteria became resistant to antibiotics. Some doctors initially treat only the symptoms of an ear infection, without antibiotics, a response that has been supported by studies on children 2 years and older.
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