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What to Do About Ear Infections


The high parental satisfaction with the eardrop treatment is important. "Parents want to walk away with a prescription in their hands," says Carvalho. "The thing is, if parents didn't want something they wouldn't come in really, because often it involves a wait in the waiting room. And if they come away with nothing they think, 'What did I come here for?'"

Pediatric ear, nose, and throat specialist Steven Handler, MD, agrees. "The U.S. has developed a culture of people who, when they go to the doctor's office, demand an antibiotic. Doctors who don't give an antibiotic are sometimes made to feel that they haven't done anything, but sometimes making the diagnosis and giving them information even though they don't need an antibiotic is very helpful," says Handler.

"We advocate, in some of the cases, that if the ears don't look that badly infected, and the kid is not that symptomatic, just him give Tylenol or Motrin," he says, noting that the pain-reliever will help the child handle the pain. Handler is associate director of pediatric otolaryngology at the Children's Hospital of Philadelphia, and a professor of otolaryngology/head and neck surgery at the University of Pennsylvania School of Medicine in Philadelphia.

But all three doctors agree there are times when a child does need an antibiotic to battle an ear infection.

"What you don't want is to be in a situation where you say don't give antibiotics, and a child develops a complication, like mastoiditis," when the infection spreads from the ear into the mastoid bone, which is part of the skull bones, says Handler. "That is where you have a problem ... and those are the situations that can be very dangerous. So it is not that no child should be treated with antibiotics, but [doctors] ought to be cautious."

Matz says that children who do not get better after 2-3 days -- who are still complaining about the pain and who have a fever -- and children under 2 (because they are believed to be at higher risk of complications), should be treated with antibiotics.

Parents should follow their child carefully. "A parent has to be assessing the child's overall activity level and fever," says Handler. "How is the child doing? How is the child sleeping, eating, and playing? Those are the kinds of things you have to look for. If the child is not any better in two to three days, go ahead and give the antibiotic."


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