ANTIBIOTICS

Antibiotics can be an excellent choice for treating ear infections. Some ear infections require antibiotics to clear the infection and to prevent them from becoming worse. This is especially likely if the child is under age 2, has a fever, is acting sick (beyond just the ear), or is not improving over 24 to 48 hours.

However, for several years there was a tendency to over-prescribe antibiotics, leading to the increasing numbers of bacteria that are resistant to these drugs. Joint guidelines from the American Academy of Pediatrics and the American Academy of Family Physicians are aimed at using antibiotics for ear infections when they are most needed. If the antibiotics do not seem to be working within 48 to 72 hours, contact your doctor to consider switching to a stronger antibiotic. Usually there is no benefit to more than two, or at the most three, rounds of appropriate antibiotics.

SURGERY

If there is fluid in the middle ear and the condition persists, even with antibiotic treatment, a healthcare provider may recommend myringotomy (surgical opening of the eardrum) to relieve pressure and allow drainage of the fluid. This may or may not involve the insertion of tympanostomy tubes (often referred to as ear tubes). In this procedure, a tiny tube is inserted into the eardrum, keeping open a small hole that allows air to get in so fluids can drain more easily down the eustachian tube. Tympanostomy tube insertion is done under general anesthesia. Usually the tubes fall out by themselves. Those that don't may be removed in your doctor's office.

If the adenoids are enlarged, surgical removal may be considered, especially if you have chronic, recurrent ear infections.Removing tonsils does not seem to help with ear infections.