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Doctors' Answers to "Frequently Asked Questions" - Ear Infections


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Ear Infection Treatment [posted 1/13/99]
Question: I had taken cipro 500 mg for two weeks for a recurrent ear infection. Then I noticed three red spots about the size of a dime on my lower abdomen. My doctor said he didn't know if this was a reaction to the drug or not. He said usually such reactions are more general. Since, he said, this drug is the only really effective drug for the type of ear infection I get, it puts me in a quandary. Was this indeed a reaction to the drug? (It could have been a spider bite possibly) and should I risk taking this drug Again?

Answer: Did you have any symptoms? Fevers, chills, pleurisy, etc.? If not I doubt it was the cipro, but there are several drugs to treat infections that are similar to cipro.

Ear Infection Recurrences [posted 12/10/98]
Question: My six month old daughter was recently on Amoxicillin for her first ear infection. Her pediatrician saw her after she had been on the antibiotic for eight days, and said it was O.K. to take her off the antibiotic, even though we hadn't finished the ten day course. Two days later, her ear infection reappeared, and she had to be put on a new antibiotic (Augmentin) for a ten day course. Was the doctor in error for having us take her off of the antibiotics so soon, or is that now an accepted practice? What are the implications for creating resistance?

Answer: No, this is about the correct time. However, some children get recurrent infections and are unable to clear them. This often leads to drainage tubes in the ear drums to avoid this problem.

Longterm Concerns for Ear Infection Treatment with Trimox [posted 10/13/98]
Question: My 5 month old son has had 4 ear infections since 3 weeks old. Dr. prescribed Trimox for 5 months after totally clear of infection this month.

  1. Is there a long term effect after 5 months?
  2. Is 5 months too long for an infant?
  3. Sleeps more in evening due to medicine during the day, is this good/not good?

Answer: There shouldn't be any long term side effects unless he develops a severe diarrhea called C. Dificil. The duration is fine since he/she is trying to prevent recurrent injections and surgery is about the only next option.

Streptococcus Pneumonae [posted 8/14/98]
Question: My son, 1 1/2 years old, has been suffering from ear infections for over 4 months or more. He now has tubes in his ears. The infection is antibiotic resistant. He has been on amoxicillin, penicillin, cefzil, and suprax. He is now also getting gentimicin directly into the ear tubes. The analysis of the culture shows 2 bacteria - streptococcus pneumonae (light growth) and moraxella catarrhalis (scant growth). The - streptococcus pneumonae was found resistant to augmentin, sephtaxine, sephtriasone, penicillin, and ofloxin among others. It was found susceptible to tetracycline, vancomycin, and erythromycin. The pediatrician recommended hospital intravenous drug administered. Why did he not recommend one of the drugs that this is susceptible to? Do they not work in the ear area? What drug treatment would be best for a child his age? Child is comfortable, no fever at present, happy, alert.

Answer: Off hand I can't tell you. The tetracycline and erythromycin are available over the counter. The difference is that you can achieve much higher levels IV than PO. I suspect he/she wants to get rid of this infection once and for all - probably the right course.

Ear Infection [posted 7/27/98]
Question: I am a 46 year old female diagnosed with a middle ear infection 10 days ago. I was prescribed 3 days of Ceclor CD, 500 mg at that time. I was fine until now, but the ear infection is back. Now I was prescribed 5 days of same drug. Shouldn't I be on antibiotics for a longer period of time?

Answer: In point of fact, we pick an antibiotic for inner ear infections based on what should work. We rarely have the bacteria identified to tailor the treatment. So, when the infection does not respond, you need a different antibiotic, the same antibiotic for a longer period, or you never had a condition that the antibiotic would affect.

Ear Infections
Question: My son (15mos) has chronic otitis media, already has tubes in both ears. Our physician keeps mentioning allergy as a possible cause. Are allergies common in 15 mos. olds? Are there allergy treatments available for children his age?

Answer: Chronic otitis media is diagnosed after several ear infections or inflammations. It is usually not responsive to antibiotics. Placement of "ear tubes" is the usual treatment if antibiotics are not effective. However, tube placement is ineffective in about 15-20% of children. At that point the usual explanation is allergies although medical science has not clearly defined the cause/effect of chronic ear inflammation not responding to "tubes". It is then common to get an allergy evaluation. Allergies in a young child are less frequent than at a later age.

Monocycline
Question: I appear to have an infection in my ear. Will Monocycline help?

Answer: Monocycline is a tetracycline like drug that is used to treat a wide variety of infections. It is especially good for skin infections like acne vulgaris. It is active against some atypical organisms like mycoplasma etc.



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