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ANN ARBOR,
MI - Virtually all children will have an ear
infection at some point in their young lives. For some, these
infections can become chronic and even dangerous. For years, antibiotics
have been widely prescribed to fight pediatric ear infections.
 Specialists
at the U-M Health System
suggest that in many cases, antibiotics might not be necessary and
that giving children frequent antibiotics can create dangerous antibiotic
resistance in society as a whole.
Ear infections
in children are so common because of the common cold, the sharing
of germs among school children, and the under-developed immune systems
of infants and toddlers.
"In an
ear infection, or otitis
media, fluid collects behind the ear drum and becomes infected
with bacteria, leading to pain or fever," says Marci Lesperance,
M.D., assistant professor, Department
of Otolaryngology. "This happens because the eustachian
tube that connects from the back of the ear drum to the back of
the nose gets plugged from colds or allergies, or because it's a
small tube."
Children with
acute otitis media will typically have fever and pain, but it's
hard for very young children to explain how they feel. Crying, irritability
and tugging at the ears can also be symptoms.
"Treatment
of an ear infection should occur when there are both symptoms of
an acute infection, along with the signs of an ear infection, such
as fluid behind the ear drum that looks like pus or infected fluid,"
says Lesperance.
"The
problem with treating ear infections with antibiotics all the time
- or treating when there may not even be an infection - is not so
much with the individual child, but with society as a whole. With
the widespread use of antibiotics, the world's bacteria are learning
to resist these antibiotics. So, it's better for society as a whole
to try to limit the use of antibiotics to the patients who really
need them," says Lesperance.
Another
treatment option: Tubes
One option
for children with multiple infections, frequent infections, or infections
that never go away is surgery to place artificial tubes through
the ear drum for better drainage. This is usually done as an outpatient
procedure that takes about 15 minutes.
Kelly Huxley
is the mother of four children, and all of them have had this surgery,
called tympanostomy tube placement.
"My oldest
was 16 months when she had her tonsils and adenoids removed and
tubes put in. She has done fine since then. My son Noah has had
the most problems," Huxley says.
"When
my ears hurted, I told my mom and she always took me to the doctor's.
I couldn't hear very good," admits Noah.
Older children
may need special tubes inserted, if tubes are needed multiple times.
Noah is on his third set of tubes.
Huxley says
the treatment with tubes clears up infections better, so the procedure
has definitely been a benefit to her family. She also notes that
now her children are sleeping better through the night.
In a tympanostomy
tube placement, a physician makes a little incision in the ear drum,
suctions out any fluid that might be trapped behind the ear drum,
and inserts a little tube to keep the hole open.
"The tube
allows a connection from behind the ear to the outside air for drainage.
These tubes stay in for roughly a year, and then usually come out
on their own. At that point, the ear drum usually heals and the
child's eustachian tube has had enough time to mature and work properly,"
says Lesperance.
Lesperance
says physicians are also concerned about fluid behind the ear drums
that isn't infected, because it is still interfering with hearing.
"They're
usually not hearing as well as they could be. So, by draining out
that fluid, we can improve their hearing and give them the best
chance at speech and language development," says Lesperance.
She also points
out that it is important to follow the advice of your child's primary
care provider on when and how to treat this common childhood malady.
Facts about
ear infections:
- Seventy-five
percent of children experience at least one episode of otitis
media, an infection or inflammation of the middle ear, by their
third birthday.
- The adenoids
of children are larger than the adenoids of adults, and this makes
children more susceptible to otitis media.
- Otitis media
left untreated may lead to hearing loss and speech and language
disabilities.
For more
information, visit the following web sites:
U-M Health
Topics A to Z: Ear Infections
http://www.med.umich.edu/1libr/child/child32.htm
U-M Health
Topics A to Z: Outer Ear Infections
http://www.med.umich.edu/1libr/topics/ent11.htm
U-M Health
Topics A to Z: Otitis Media (Middle Ear Infection)
http://www.med.umich.edu/1libr/topics/ent09.htm
Centers for
Disease Control: Ear Infection Facts
http://www.nidcd.nih.gov/health/parents/otitismedia.htm
FDA: Antibiotic
Resistance, A Growing Threat
http://www.fda.gov/oc/opacom/hottopics/anti_resist.html
Centers for
Disease Control: Antibiotic Resistance
http://www.cdc.gov/antibioticresistance/
Written by Mary Beth Reilly
For more
information, contact Mary Beth Reilly or Carrie Hagen, UMHS
Public Relations, 734-764-2220, or by e-mail.
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