Ear Infections in Children: Symptoms, Treatment, and Recovery

Pediatric Otitis Media

Hello, doctor.
My 5-year-old child yawned the day before yesterday evening and then complained of pain in the left ear.
About 20 minutes later, the pain subsided, but he went to see an otolaryngologist who diagnosed him with external ear canal inflammation and prescribed Decason ear drops to be used three times a day for one day.
However, the next day at noon, he again complained of ear pain, especially when running or jumping.
After using the ear drops, the pain went away for about 20 minutes, but by 3 PM, he was in unbearable pain, so we took him to another otolaryngologist.
This doctor diagnosed him with severe otitis media in the left ear with fluid accumulation and mild otitis media in the right ear.
The following medications were prescribed:
1.
DICLOFENAC 25mg, 0.66*4 times a day for 3 days
2.
INOLIM Tab 3mg, 0.33*4 times a day for 3 days
3.
Periactin 4mg, 0.50*4 times a day for 3 days
4.
AMOXICILLIN 500MG, 0.50*4 times a day for 3 days
5.
AUGMENTIN 625MG, 0.08*4 times a day for 3 days
6.
ENDASE 0.33*4 times a day for 3 days
I have a few questions for the doctor:
1.
Are these medications and dosages appropriate for a child?
2.
If these medications are effective, will the ear still hurt?
3.
If the treatment is effective, how long will it take for the fluid in the middle ear to resolve?
4.
If these medications are ineffective, will surgery be necessary, or are there other treatment options available?
Thank you for your response, doctor.

vivian, 20~29 year old female. Ask Date: 2017/11/27

Dr. Li Jiaxuan reply Otolaryngology

1.
Pediatric medication dosages are related to body weight.
Should all the above medications be taken together?
2.
Otitis externa often causes pain, while otitis media is primarily associated with hearing loss.

3.
It varies depending on the amount of fluid accumulation, but after effective treatment, the mother should notice that the child feels more comfortable in about 2-3 days.

4.
Tympanostomy is usually performed after three months of medical treatment, except in cases where children experience severe complications from middle ear effusion.

Reply Date: 2017/11/27

More Info

Understanding ear infections in children, particularly middle ear infections (otitis media), is crucial for parents and caregivers. Ear infections are common in children, especially those under the age of five, due to their anatomical and physiological characteristics. Here’s a comprehensive overview based on your questions and the context provided.

Symptoms of Ear Infections
Children with ear infections may exhibit a variety of symptoms, including:
1. Ear Pain: This is often the most prominent symptom. Children may pull at their ears or express discomfort, especially when lying down or during physical activities.

2. Fever: A mild to moderate fever can accompany an ear infection.

3. Irritability: Increased fussiness or irritability, especially in younger children, can indicate discomfort.

4. Hearing Issues: Temporary hearing loss may occur due to fluid buildup in the middle ear.

5. Fluid Drainage: In some cases, fluid may drain from the ear, which can be a sign of a ruptured eardrum.

Treatment for Ear Infections
The treatment for ear infections can vary based on the severity and frequency of the infections:
1. Antibiotics: For bacterial infections, antibiotics like Amoxicillin or Augmentin are commonly prescribed. The dosage and duration depend on the child's age, weight, and the severity of the infection. In your case, the prescribed medications seem appropriate for a child, but it's essential to follow the pediatrician's guidance regarding dosage.

2. Pain Management: Medications such as Diclofenac can help manage pain and inflammation. Over-the-counter pain relievers like acetaminophen or ibuprofen are also effective.

3. Observation: In some cases, especially with mild infections, doctors may recommend a watchful waiting approach, as many ear infections resolve on their own.

4. Surgery: If a child experiences recurrent ear infections or if fluid persists in the middle ear for an extended period, surgical options like tympanostomy (ear tubes) may be considered to prevent future infections and improve hearing.

Recovery and Monitoring
1. Duration of Symptoms: If the prescribed medications are effective, pain should decrease within a few days. However, the presence of fluid in the middle ear may take longer to resolve, typically a few weeks.

2. Follow-Up: It’s crucial to have follow-up appointments with the pediatrician or an ENT specialist to monitor the child’s recovery and hearing. If symptoms persist or worsen, further evaluation may be necessary.

3. Signs of Complications: If the child develops a high fever, severe pain, or drainage of pus from the ear, it’s essential to seek medical attention promptly, as these could indicate complications.

Conclusion
In summary, ear infections in children can be effectively managed with appropriate medical care. The medications prescribed for your child appear to be suitable, and with proper adherence to the treatment plan, symptoms should improve. Always consult with your healthcare provider if you have concerns about your child's condition or if symptoms do not improve as expected. Regular monitoring and follow-up are key to ensuring your child's health and preventing future infections.

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