Otitis

Otitis Treatment in Dubai

Overview

Acute otitis media (AOM) is defined by the presence of fluid in the middle ear accompanied by acute signs of illness and signs or symptoms of middle ear inflammation. Bulging of the tympanic membrane (TM) is considered the quintessential sign that distinguishes AOM from otitis media with effusion and a normal TM

Epidemiology:

Acute otitis media (AOM) is the most frequent diagnosis in sick children visiting clinicians’ offices and the most common reason for administration of antibiotics. AOM occurs at all ages but is most prevalent in infancy.

Risk Factors:

A number of risk factors for AOM have been established, the most of important of which is age.

1-Age – The age-specific attack rate for AOM peaks between 6 and 18 months of age. After that, the incidence declines with age, although there is a small increase between five to six years (the time of school entry). AOM is infrequent in school-age children, adolescents, and adults

2-Family history

3-Day care – The spread of bacterial and viral pathogens is common in day care centers

4-Lack of breastfeeding

5-Tobacco smoke and air pollution

6-Pacifier use

7-Others: -Social and economic conditions (poverty and household crowding increase the risk)

-Season (increased incidence during the fall and winter months)

-Altered host defenses and underlying disease

 

Causes of Otitis

  • Three species of bacteria account for most of the bacterial isolates from middle ear fluid: Streptococcus pneumoniae , nontypeable Haemophilus influenzae , and Moraxella catarrhalis
  • It can be caused by other bacterias or by viruses

 

Symptoms of Otitis:

  • Children with acute otitis media (AOM), particularly infants, may present with nonspecific symptoms and signs, including fever, irritability, headache, apathy, anorexia, vomiting, and diarrhea
  • Ear pain (otalgia) is the most common complaint in children with AOM and the best predictor of AOM However, ear pain and other ear-related symptoms (eg, ear rubbing) are not always present
  • The most important sign for distinguishing AOM from otitis media with effusion and normal is the presence of bulging of the tympanic membrane

 

Otitis Treatment

Treatment of an ear infection may include:

  • Antibiotics
  • Medications for pain and fever
  • Observation
  • A combination of the above

The “best” treatment of otitis depends on the child’s age, history of previous infections, and any underlying medical problems.

Antibiotics  — Antibiotics may be of value for children in whom the diagnosis of ear infection is certain and/or children who have severe symptoms. Antibiotics are of benefit for infants under two years of age in whom the diagnosis of ear infection is certain. Children two years of age and older with mild symptoms may be observed initially and most will heal without antibiotics.

  • Antibiotics are usually given to infants who are younger than 24 months or who have high fever or infection in both ears
  • Children who are older than 24 months may be treated with an antibiotic or may be able to be observed to see if they improve without antibiotics

Antibiotics are not given to every child with an ear infection because studies show that many older children with ear infections improve without using antibiotics. Antibiotics can have side effects such as diarrhea and rash, and overusing antibiotics can lead to more difficult to treat (resistant) bacteria. Resistance means that a particular antibiotic no longer works or that higher doses are needed next time.

Observation  — In some cases, your child’s doctor or nurse will recommend that you watch your child at home before starting antibiotics; this is called observation. Observation can help to determine whether antibiotics are needed.

Observation may be recommended in these situations:

  • If it is not clear whether the child has an ear infection, based upon the exam
  • If the child is older than 24 months
  • If ear pain and fever are not severe
  • If the child is otherwise healthy

You can give pain-relieving medicines during observation to ease pain.

If your child is being observed rather than treated with antibiotics, you will need to call or go back to the doctor or nurse’s office after 24 hours for follow-up. If your child’s pain or fever continues or worsens, antibiotics are usually recommended; observation may continue if the child is improving.

Follow-up — Your child’s symptoms should improve within 24 to 48 hours whether or not antibiotics were prescribed. If your child does not improve after 48 hours or gets worse, call your doctor or nurse for advice. Although fever and discomfort may continue even after starting antibiotics, the child should get a little better every day. If your child appears more ill than when seen by his or her health care provider, contact the provider as soon as possible.

Children who are younger than two years and those who have language or learning problems should have a follow-up ear exam two to three months after being treated for an ear infection. These children are at risk for delays in learning to speak. This follow-up helps to ensure that the fluid collection (which can affect hearing) has resolved.

Consult the doctors at SHAMMA Clinic to effectively diagnose and treat otitis. Book an appointment with our doctors today.

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