Ear Infections: Otitis Media With Effusion
What is otitis media with effusion?
Otitis media with effusion means that there is fluid in the middle (inner) ear and that the inner ear is inflamed (swollen). (Effusion is another word for fluid.) This fluid usually doesn't bother children. It almost always goes away on its own. So, this kind of ear problem doesn't usually need to be treated with antibiotics, unless the fluid doesn't go away.
What are the symptoms of otitis media with effusion?
The symptoms of otitis media with effusion include the following:
- Fluid that drains from the ears
- Pain inside the ear (if your child is too young to speak and tell you his or her ear hurts, he or she may tug at the ear often)
- Trouble sleeping
- Irritability
- Fever
- Headache
What causes otitis media with effusion?
Fluid may build up in the middle ear for several reasons. When a child has a cold, the middle ear may produce fluid just like the nose does, but the fluid doesn't drain out of the middle ear as easily as it does from the nose. Children who have a "regular" ear infection could also develop otitis media with effusion the next time, if the fluid stays in the middle ear for a long time. Otitis media with effusion can be caused by swollen adenoid tissues, which are located in the upper throat and can block fluid from draining.
How is otitis media with effusion treated?
If your child is older than 6 months of age and only has mild symptoms, the best treatment is to let the fluid go away by itself. You can give your child an over-the-counter pain reliever, such as acetaminophen, (one brand: Children's Tylenol) if he or she is uncomfortable. A warm, moist cloth placed over the ear may also help.
FDA Warning
The. U.S. Food and Drug Administration (FDA) advises against the use of ear candles. Ear candles can cause serious injuries and there is no evidence to support their effectiveness. For more information, please visit the FDA Web site.
Are antibiotics ever needed for an ear infection with fluid?
Yes. If the fluid is still there after a few months and is causing hearing loss or problems in both ears, antibiotics may help some children. For this reason, your child's ears should be checked a few months after an ear infection. If the fluid is still there, a hearing test may be the next step. Your doctor may also recommend antibiotics if your child is under 6 months of age or gets frequent middle ear infections.
Why not just try antibiotics right now?
Giving your child unnecessary antibiotics can be harmful. After each course of antibiotics, the germs in the nose and throat are more likely to become resistant. Resistant germs can't be killed by the usual antibiotics. More expensive and powerful antibiotics have to be used. Some of these antibiotics must be given in the hospital and their side effects can be very unpleasant or even dangerous. Since fluid in the ears doesn't usually bother children, it's better to wait and only give antibiotics when they're necessary.
References
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Appropriate Use of Antibiotics for URIs in Children: Part I. Otitis Media and Acute Sinusitis by SF Dowell, M.D., M.P.H., B Schwartz, M.D., WR Phillips, M.D., M.P.H., and The Pediatric URI Consensus Team (American Family Physician October 1, 1998, http://www.aafp.org/afp/981001ap/dowell.html)