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What is Middle Ear Infection? Print E-mail
Written by Adrian Wozniak   
Wednesday, 28 October 2009

Acute otitis media is a bacterial or viral infection of the middle ear.

What is going on in the body?
The three parts of the ear are the outer ear, the middle ear, and the inner ear. The eustachian tube connects the middle ear to the nasal cavity. The eustachian tube keeps equal ear pressure between the eardrum and the outside of the body. Any secretions formed in the middle ear flow into the nasal cavity through this tube.

Otitis media often begins when a virus, such as the one that causes colds, enters the nose. The virus travels into the eustachian tube and causes it to swell. The virus can also travel up the eustachian tube to the middle ear. When the swollen tube does open, bacteria enter the tube and the middle ear. Bacteria multiply, causing an acute infection.

What are the causes and risks of the condition?
Otitis media is an infection caused by a virus or bacteria. The following children are at higher risk for this type of infection:
- children in day care
- children under the age of 3 or 4 years
- children who live with smokers
- children who take bottles to bed
- children whose parents had childhood otitis media
- children with chronic allergies or sinusitis
- Native American and Eskimo children

Individuals who have very small or poorly functioning tubes are also at a higher risk for infections. Children with head and face abnormalities often have eustachian tube problems. This includes children with Down syndrome and cleft palate.

What are the treatments for the condition?
Up to 60% of cases of acute otitis heal without antibiotics. Antibiotics are generally used to reduce the symptoms, make the child more comfortable, and prevent serious complications. Common antibiotics for ear infections include:
- amoxicillin
- amoxicillin combined with clavulanate
- azithromycin
- ceftriaxone
- cefuroxime
- clarithromycin
- erythromycin and sulfisoxazole
- trimethoprim and sulfamethoxazole

If the child does not respond to the antibiotic, the dose may be increased or the antibiotic may be changed. If a child has repeated infections, surgery to insert ear tubes may be performed.

What are the side effects of the treatments?

Antibiotics may cause stomach upset, diarrhea, and allergic reactions. Surgery can cause bleeding, infection, and allergic reaction to anesthesia.

What happens after treatment for the condition?
If the infection has been properly treated, the fluid behind the eardrum usually goes away with time. As long as fluid is present, there will be some hearing loss. Once the fluid goes away, hearing will return to normal. If the fluid lasts for more than 3 months, it will probably not go away. The healthcare provider may recommend ear tube insertion at that time.

How is the condition monitored?
The condition is mostly monitored by the child's symptoms. Some healthcare providers recommend a return visit after the antibiotics are gone. Any new or worsening symptoms should be reported to the healthcare provider.


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