Need Ear Infection Advice/Reassurance, Please

[Wife_and_mommy]

DS was diagnosed with an ear infection a month ago after having his first fever. He was given a script that I didn't have filled until two weeks later when his ears were still red and the doc heard he's had a rattly(sp) chest since December. His hypothesis was that the ear inf. had started in Dec. after a common cold and recommended that he take the antibiotic. The doc knows I'm conservative when it comes to medical care so agreed.

Now I'm second-guessing myself. DS finished the anti a few days ago then woke up last night with another fever. I pulled out a Robert Mendohlson book I have that says to only use the antis if pus is coming out of the ear which isn't the case here.

I'm at a(nak) loss now for what to do. I'm concerned that i might have begun a vicious cycle of antibiotic use. it's been easy to be conservative when my kids are healthy.

my kids are going wacky so i have to stop typing but i appreciate any thoughts anyone might have.

tia,




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[Radosti]

OK, well... let me start by saying that I respect your parenting choices and understand why you are worried. That said, this is a sore topic with me, so please understand that I don't mean any criticism by this, just advice.

I am an infectious disease microbiologist. OK, so this is my opinion. What started as a simple cold, caused fluid in your DS's ear. This in turn caused an ear infection. An ear infection left unchecked can be very dangerous because the bacteria continue to divide in a space that doesn't provide too much room. The best way to treat it is to catch it right at the beginning.

If you don't feel that antibiotics are warranted, take a cotton ball, put some oil on it, heat it up a little bit (not enough to burn, just enough to expand the oil a bit) and place it in DC's ear. This works because most of the ear infection bacteria are aerobic (require oxygen to survive), by blocking the oxygen with an oil wetted cotton ball, you are removing the source of oxygen and thus oxygen starving the bacteria.

But, if this doesn't help within a day or two, antibiotics should be the next step. It's all well and good to say wait until pus comes out of the ear, but unfortunately the progress of infection isn't an easy one to predict. My neighbor across the street died because he had an ear infection, let it go, and instead of bursting out (where the pus comes out of the ear), it burst inwards and the bacteria travelled to his brain. He went to bed complaining of a headache and was dead by morning. While this is a rare event, I know two families whose kids are now deaf because their parents didn't treat the infections (taking a very conservative approach).

Antibiotics work best when the bacteria is in the Log phase of growth, rapidly dividing. This is because most antibiotics attack a dividing membrane. Not when the bacteria has reached a point where the person is now septic. That requires doses of wide-spectrum IV antibiotics and lots of supportive care. I had a technician in my last job that had a chest infection and I kept telling him to go to the doctor. He kept saying that his system is strong enough to fight it off. Well, one day I walked outside and he is laying on the picnic table in 101F weather, in full sun, and he was pale and shaking like a leaf. He was also barely coherent at that point. I called an ambulance and he spent the next 3 weeks in the hospital. For something that could have simply been treated at the right time with a course of antibiotics.

While I still consider myself pretty conservative and will not overdo antibiotics, I don't believe that they are the evil substances that people tend to believe they are. The black plague is no longer the scourge it once was due to the invention of antibiotics.

Anyway, if you had read this far, thank you. My opinion is that your DS's infection had gone too long, and is now at the point that maybe the Amoxicillin can't touch it. So, he may need a round of a stronger antibiotic. It will not start a vicious circle of antibiotics, don't worry. But you do need to treat the infection.

OR... your DS could have picked up another cold (a virus) already and the fever is completely unrelated to the ear infection/antibiotic. And an antibiotic does nothing for viruses. I'd still check with your pediatrician to re-check the ear.

[psophia17]

Rada - thank you for that explanation! I'm opposed to over-medicating, but ITA that if it's a real infection, nipping it in the bud is the way to go.

To the OP - N had his first round of abx in January (he had the same thing we all had, the cold/fever that's been going around, but he was way sicker and the doc said he had puss on his left tonsil and abx were the way to go). He took the full course of abx, and no vicious cycle has started.

IIRC, so long as the full course of abx gets taken, and the abx used is effective against the infection, you can avoid the vicious cycle.

Anecdote here - in HS, there was a girl who was forever sick. Turns out her mother had a medicine cabinet filled with all sorts of abx, the leftovers, which should never, ever happen with abx. When the kids got sick again, she'd switch to some other abx in her stores. She's probably responsible for some of the drug resistant bugs that are running around these days...

[roysmom]

I am, by far, no expert in medicine, but if you are going to take your child to the doctor, shouldn't you follow their advice? They did go to med school so they could learn what to and not to give our children.

Okay, off my soapbox now. My DS had 4 ear infections in 3 months. We eventually had tubes put in and they work great. If you let an ear infection go too long untreated, it can cause deafness. I know that, as a mother, you would not want this for your child.

Not to criticize, I just don't understand not giving your child medicine that would help treat an illness.

[o_mom]

I think that waiting for pus coming out the ear is too long - at that point the ear drum is perforated and has probably caused the child significant pain. OTOH, treating every little bit of red in the ear is overkill. We usually wait if possible and many times they do clear up. It is harder at your DS's age when they can't tell you if it is getting better or worse, though.

I would take him back to have another look at the ears and see if it has cleared up or if this is just an unrelated cold/fever. I don't think that waiting was wrong since most ear infections (something like 80%) will clear on their own. What is more likely is that the infection was resistant to amoxicillin (not uncommon).

[LarsMal]

I try not to run to the ped every time DS has a cough or sneeze. I also try not to medicate him unless he is just miserable.

OTOH- if he has a fever, I always call the ped, even if it's just to find out if it's something he *should* be seen for. I have learned, for DS, a fever means infection. I can't imagine not treating his ear infections with antibiotics. I would feel so horrible if it got worse and turned into something else. Part of that is b/c DH had terrible ear problems when he was little. I think MIL ignored them until it got really bad, and now he has terrible ear problems as an adult, as well as some hearing loss.

I completely understand not wanting to overmedicate, but I think if you catch it early enough you have a better chance of *not* needing more meds.

**Not to totally freak you out, but there was a story on the news last night about a little boy who died of a tooth infection. The mother was having trouble with her insurance so she ignored the infection, it spread to his brain, and he died. So sad.

[Wife_and_mommy]

R,

Thank you for your explanations!! I *really* appreciate you taking the time to share it with me.

In my defense, ds went to the doc because of the fever(they're rare in our house and dh insisted which I'm glad for now). He was acting a little fussy/clingy but nothing that couldn't be chalked up to teething or normal tiredness. He's had little respite from colds since Dec. I was flabbergasted when the doc said he had an ear infection. FYI, ds has always been a fussier baby than dd was so dh/I didn't really see much difference in his demeanor.

The one doc(there are two) gave me the script but wasn't opposed to me waiting it out after we discussed. I wish I'd known about the cotton ball deal as I would have tried it(don't think ds would have been agreeable but I'd have tried). I saw the second doc and he's the one who said we should do the anti's so I agreed.

I had been planning on getting his ears checked again this week or next when this fever turned up last night. Both the kids have had these little pin prick spots on their legs which I attributed to a virus. I'm sure dd is jsut a virus while I'm just plain worried that ds's situ might be the former you described. It's very reassuring to know that it may not be as dire a situ as I'm imagining.

Again, I really appreciate you sharing your time and knowledge with a concerned mommy. Having this info from a secondary reliable source is reassuring to me regardless of how much I trust my docs.

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[Wife_and_mommy]

Um, no. I hear my doctor's advice and then research and talk with others more knowledgable than myself so I can make a informed decision. Doctors are educated but they don't know everything. It's my/dh's job to decide what's best for our children, not any doc's.

I would/did give him the meds. This new fever is what's confused the dickens out of me.



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[Wife_and_mommy]

Thank you for your response.

The plan was to take him back to get checked but it's become more urgent now. I also didn't know amox-resistance was common. Another thing to discuss.....

This is only the second fever I've dealt with. DD's was a simple virus at 8M. Most illnesses in our house are the common cold.

Our appt is today at 4:20. Please wish ds healthy ears.




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[o_mom]

I'm not sure of the exact statistics on resistance. I have seen 5-15% are resistant to amox, so while not the majority it is not uncommon. Amox is the first choice for many reasons. It is cheap and it does work against many ear infections, especially in kids that have not had many. They want to save the 'big guns' for those that are truely resistant.

[crayonblue]

I was also under the impression that waiting until pus is coming out is too long because by then the ear drum is perforated. Believe me, I know about that as my mom was very anti-antibiotics and I had numerous ear infections as a kid which always resulted in a perforated ear drum and extreme pain.

If I were you, I wouldn't second guess myself on this one. You did what the doctor recommended and what most of us would have done. You don't want to mess around with ears, in my opinion.

[ctmom]

thank you for the very informative post!

Mary
dd#1 2/01
dd#2 12/03

[purpleeyes]

I had lots of ear infections as a kid... and I got one last summer, too, at 30 years old!! Any age, they are yucky so I just wanted to say that I hope DS has a good check-up. Keep us posted!!

[npace19147]

Also, don't forget that at this time of year there's all kinds of stuff going around. This fever could be totally unrelated. My DD had two ear infections almost back-to-back, one of which went away on its own, the other one needed abx, and the dr's were pretty confident they were unrelated and the timing was a coincidence.

Hope you get good news at your appt!

[Wife_and_mommy]

So I was worried for nothing. DS was diagnosed with Fifth Disease. He got it from DD as she had the same rash though no fever last week.

The doc said it's very common in the preschool/kinder crowd and very contagious. Since the kiddos don't get very sick, moms(me included) think they're fine and continue to expose them to others.

The even better news is that his ears look great. He did warn me that boys have a higher incidence for EI's(talk about sexism...)so he might come down with another one come spring. I'll be on the lookout now that he's had one and I know what to look for.

I appreciate everyone's responses.

ETA: Just wanted to say, FTR, that I am not anti-meds across the board. I prefer no meds but do take/give them when necessary.



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[Wife_and_mommy]

L,

Thanks for sharing your experience.

The book's author didn't talk about any pain associated with the perf. It's kind of disturbing to me, to be honest, that he sees no problem with waiting that long but maybe he intends it for older kids than mine. I wouldn't knowingly cause them pain so I appreciate the info.

Thank you for the encouragement. It's just what I needed. :)


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[JBaxter]

This wont do you much good for this ear infection but I am a big believer in garlic oil drops for ear infections. I have a brand called Mullins I got from whole foods. I warm in a cup of water and put 2 drops in the ear then the cotton ball. Garlic is supposed to have natural antimicrobic properties. 2x this winter Nathan said his ear hurt and it seemed to clear it up in 24hrs.

[Radosti]

Jeana,

That works mostly because the garlic oil combined with the cotton ball are oxygen starving the bacteria. It's an old remedy, although mostly any oil will work.

[Radosti]

I'm glad to hear that your DS's ears have cleared up. Picking up the next illness while recovering from this one is pretty common.