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Baby Has an Ear Infection

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Antibiotic Balancing Act

If your child hasn't been vaccinated, or gets an infection anyway, your pediatrician will typically prescribe the antibiotic amoxicillin. The most acute symptoms should subside within 24 to 48 hours, but since the pain may continue for several days, acetaminophen and warm compresses may help relieve discomfort.

Make sure to administer the antibiotics for the prescribed time, or the infection might stick around, and your baby could need a new round of antibiotics, possibly a different kind, such as Ceclor, Augmentin, Ceftin, and Rocephin.

Concern about antibiotic overuse and the development of drug-resistant bacterial strains, has prompted doctors to look more carefully at ear infection symptoms before prescribing antibiotics. If a baby has acute otitis media, not the less-serious OME, the doctor is likely to prescribe a stronger dose of amoxicillin twice a day rather than the traditional three weaker doses, says Magit. Other, more powerful, antibiotics are reserved for harder-to-treat cases, particularly in children under 2.

Doctors are also now less likely to offer prophylactic therapy -- taking a low-dose antibiotic for several months to prevent recurring ear infections -- particularly during the winter cold season.

"People are shying away from using [antibiotics prophylactically] because of the concerns about resistance," says Dr. Magit. "It works, but you're giving a child a lot of antibiotics to prevent one ear infection."

Those Pesky, Recurring Cases

So what do you do if your baby has repeated ear infections or ones that don't respond to treatment? If a child has persistent fluid buildup, lasting more than a few months, more than three ear infections in six months, or more than four in a year, your pediatrician may suggest other options.

Persistent fluid buildup prevents the eardrum from moving back and forth properly and can cause hearing difficulties. Although hearing loss typically isn't permanent, it still may be a problem for young children who are just learning language.

When antibiotics aren't enough, the most common recommendation is an outpatient surgical procedure in which small tubes, called tympanostomy tubes, are inserted through the eardrum to promote drainage. In most cases, this helps reduce the number and severity of infections.

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