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Ear infections

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of ear infections.

Alternative Names

Otitis media

Highlights

Acute Otitis Media (AOM)

• “Watchful waiting” significantly reduces the unnecessary use of antibiotics and poses no health risks for children, indicates a 2006 Journal of the American Medical Association ( JAMA ) study. Experts recommend that for most cases of AOM, antibiotics should be withheld for 2 – 3 days to see if the ear infection resolves on its own.
• Both bacteria and viruses are common in AOM, suggests a 2006 study. Viruses can increase ear inflammation and prevent antibiotics from working properly.

Otitis Media with Effusion (OME)

• Persistent fluid in the middle ear does not cause developmental delays, indicates a 2007 New England Journal of Medicine study. This important study also suggests that early insertion of ear tubes to drain fluid is not necessary for most children with OME.
• Antihistamines and decongestants do not work for OME and may cause more harm than good, according to a 2006 Cochrane study.

Chronic Otitis Media

Chronic cases of otitis media, both with and without effusion, may be caused by “bacterial biofilms”-- slimy collections of bacteria that are resistant to antibiotics, according to a 2006 JAMA study. The discovery of these biofilms provides further evidence that antibiotics do not help chronic otitis media.

Acute Otitis Externa (AOE)

AOE, also called “swimmer’s ear,” is best treated with topical — not oral — antibiotics, according to new clinical guidelines. With eardrops, most cases of AOE clear up within 2 – 3 days.

Prevention

• The flu vaccine helps prevent ear infections. New immunization guidelines recommend an annual flu vaccine for all children ages 6 months – 5 years.
• Keeping children younger than age 1 out of day care may help prevent the upper respiratory infections that frequently lead to ear infections.
• Ear infections can sometimes run in families. New research suggests that breastfeeding can help prevent ear infections even in children who are genetically predisposed to them.

• Review Date: 3/6/2007
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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