Antibiotics for otitis media in children

Ear inflammation is a very unpleasant and contentedly dangerous disease that every child has had at least once in his life. Otitis media according to medical statistics are in fourth place in terms of frequency of occurrence. Before them - only viral infections (influenza and SARS), and ENT diseases - bronchitis and tonsillitis.

Pediatricians state that in the epidemic seasons every fifth small Russian suffers otitis media. At risk are children of any age, but more often than others, babies under 3 years old are susceptible to the disease. This is dictated by the structural features of the child's ear (non-final formation of the ear canal) and the "looseness" of the mucous membranes in childhood.

Most parents are interested in whether antibiotics are needed to treat otitis media or whether they can be dispensed with. There is no definite answer. It all depends on what kind of otitis media happened to your baby.

Otitis media are external, middle and localized in the inner ear. And their stages range from mild to moderate to acute and catarrhal. It is precisely, depending on the stage of the disease, that the question of prescribing an antibiotic to the child will be decided.

The symptoms of otitis media are not difficult to recognize. The child complains of shooting or sharp pain in the ear, headache. The baby may have a fever, hearing loss, and with purulent otitis media, a specific liquid mixed with pus is released from the auricle.

A mobile and active toddler becomes lethargic, painful, sleepy and moody, his appetite disappears.

Do you need antibiotics?

It should be noted that only 10-11% of children with otitis media need antibacterial therapy. This mainly applies to cases of purulent otitis media. If you find symptoms of otitis media, you should not decide on the treatment yourself, take your baby to the doctor. If, upon examination, the doctor does not detect signs of the presence of a virus in the body (runny nose, high fever, dry cough, etc.), then he may suggest otitis media of bacterial etiology in a child. And then the question of taking antibiotic drugs will certainly arise.

In the next video, Dr. Komarovsky will tell you when to use antibiotics to treat otitis media.

When are antimicrobial agents not needed?

Children who have crossed the age of 2 years with mild to moderate otitis media. For the first two days the doctor will try to treat otitis media with alternative methods - he will recommend pain relievers (Panadol, Nurofen, etc.), vasoconstrictor nasal drops, and will also tell you how to make a warming alcohol compress. In a couple of days, it will become obvious where to go next. If the immunity of the crumbs copes with the infection, the symptoms of otitis media will be alleviated. If not, antibiotics are worth considering.
Children who have otitis media as a complication of a previous viral infection (influenza or ARVI). Everything is pretty simple here. Antibiotics are only effective against bacteria. Viruses are beyond their control. An antibiotic will not help, but it can harm the child.
Children over 2 years old, who do not have a fever and moderate earache, do not need an antibiotic in order not to have an immunosuppressive effect on the growing body. In other words, such a baby may well cope with the infection himself with the help of his own defense system.

Indications for appointment

In cases where otitis media is diagnosed in a newborn and a child under 2 years of age.
If the body temperature of the crumbs rises above 39 degrees and lasts more than 2 days.
When visual inspection confirms the presence of pus in the ear.
If the baby has visible signs of severe intoxication.

The most frequent "culprits" of otitis media in childhood are the well-known staphylococcus and hemophilus influenzae from the school biology course. Antibiotics of the penicillin family, as shown by recent medical research, are, alas, ineffective against pests that cause ear inflammation. However, they can cure mild forms of the disease. In addition, relatively "soft" and "delicate" penicillin drugs will be an excellent start in therapy. If there is no relief after a couple of days, the pediatrician or ENT doctor will change the antibiotic to another.

For the treatment of the acute form of the disease and catarrhal otitis media, as a rule, antibiotics of the cephalosporin type and macrolides are used. They are more powerful, most bacteria have nothing to oppose to them. However, the list of side effects and contraindications for such funds is much wider.

The form of the antibiotic also matters. Syrups, tablets and suspensions can be taken in the treatment of ear inflammation. But with a complex stage of the disease, for example, with purulent otitis media, doctors prefer to prescribe injections.

List of antibiotics

"Amoxicillin". An antibiotic of the penicillin group, which is widely used in the treatment of acute otitis media. Newborns and babies under 5 years of age are advised to use an antibiotic in an easy-to-take suspension form. From 7 years old - in tablets, teenagers from 12 years old - in capsules.

"Unidox Solutab". Antibiotic drug tetracycline, which helps in the treatment of all forms of otitis media. In pharmacies, it is sold in the form of dissolving tablets. The medicine is not prescribed for children under 8 years of age. And in general, pediatricians "dislike" tetracyclines due to the abundance of side effects.

Augmentin. This penicillin drug has proven itself as a treatment for otitis media. Higher dosages of this antibiotic are used to treat otitis media. For babies, a suspension form is suitable, which can be prepared from granules purchased at a pharmacy. For older school children - pills. The doctor can prescribe "Augmentin" for injections to a patient of any age, if he considers it necessary.

Clarithromycin. Antibiotic is a semi-synthetic macrolide. Doctors prescribe this drug for various forms of otitis media. For children over 6-7 years old, the drug can be given in tablets, after 12 years - in capsules. There is no other form of Clarithromycin release. The doctor calculates the children's dosage of the antibiotic, taking into account the age and weight of the child, as well as the stage and characteristics of the form of the disease.

"Azithromycin". An antibiotic macrolide, which is often prescribed to children with otitis media and exacerbations of a chronic disease. It comes in capsules and tablets. Not recommended for children under 12 years of age.

Sumamed. This macrolide-azalide antibiotic is also a fairly common treatment for an inflamed middle ear. The medicine is prescribed if the child is already 6 months old. The antibiotic can be used in suspension, in tablet form, or in capsules. Sometimes doctors recommend Sumamed in injections.

"Suprax". An antibacterial agent of a cephalosporin drug is prescribed in capsules or suspensions for the treatment of otitis media, mainly of acute or moderate forms of illness for children from birth. However, up to six months, the medicine should be given with extreme caution, it is better - in a hospital under the supervision of specialists.

"Klacid". A fairly well-known antibiotic of the macrolide family. It is often recommended in the treatment of all forms of hearing inflammation. The existing pharmaceutical forms of the antibiotic give freedom of action to both doctors and parents. The drug can be given to a child in the form of a suspension, in tablets, as well as injected intramuscularly or intravenously. The doctor calculates the dose, he also decides on the advisability of prescribing "Klacid" to children under 1 year old.

Ceftriaxone. Antibiotic of the third generation cephalosporin group. The drug is relevant for complex forms of the disease, when immediate antibiotic therapy is required. In case of complicated otitis media of a purulent form, the medicine will be prescribed in the form of injections. The drug is given to children from birth with strict adherence to the dosage regimen.

"Cefazolin". First generation cephalosporin. It is available only in the form of powders for the preparation of injections, and therefore his doctor can prescribe a child if the otitis media is neglected or purulent, as well as in cases of severe course of other forms of the disease. The medicine is prescribed for children from 1 month of age.

"Cefipim". A fourth-generation cephalosporin antibiotic is prescribed in exceptional cases. If the otitis media is severe, and other antibiotics have not helped. The only form of release is a dry substance for the subsequent preparation of infusions (injections). It is a strong antibiotic with a long list of side effects. For newborns and infants, the drug is usually administered in a hospital under the round-the-clock supervision of doctors.

Cefuroxime Axetil. The second generation cephalosporin has proven itself to be excellent in the treatment of ENT diseases, including otitis media. It is commercially available in two forms: dry substance for injection and tablets. The medicine can be used in newborns and children under 1 year old (in injections). Babies from 5-6 years old are allowed to take the tablet form of the drug.

Omnitsef. This is a third-generation cephalosporin group drug that is prescribed for most forms of otitis media. The medicine on the shelves of pharmacists exists in the form of a dry substance for subsequent dilution for injections and in tablets. The drug is contraindicated in crumbs that have not reached six months.

Ear drops

If otitis media is relatively mild, injections and suspensions can be dispensed with. Local antibiotics will help. With complex forms of the disease, as well as with intense, severe ear pain, drops can be a good addition to the main treatment prescribed by a doctor. When it comes to antibiotic drugs, the following drugs are usually prescribed:

"Candibiotic". This is a combination medicine that contains an antibiotic (chloramphenicol) and a hormone. The medicine significantly alleviates the condition of the baby with external inflammation in an acute form, with inflammation of the middle ear, and even with an exacerbation of the manifestations of a chronic ailment. The drug is dripped into the ears 4-5 drops four times a day. The average course of therapy is from a week to ten days. Manufacturers do not recommend using Candibiotic for children under the age of six.

"Drops" Anauran ". The solution contains two antibiotics, as well as lidocaine, which quickly relieves severe pain. This medicine is recommended to be instilled in case of acute inflammation and chronic ailment of the outer ear, as well as the acute stage of otitis media. The solution is injected into the auricle with a special pipette-dispenser four times a day, two to three drops into the sore ear. It is not recommended to use Anauran for more than a week. If the child is not yet 1 year old, the drops should be used with extreme caution to avoid the development of an allergic reaction.

«Otofa ". Antibiotic drops without impurities of other components. At the heart of it is rifamycin, a fairly effective antibiotic. The solution helps with inflammation of the outer ear, it is also prescribed to children in case of diagnosis of an acute form of inflammation of the middle ear, with a chronic ailment, even with damage to the membrane. In addition, the remedy has shown itself to be the best in the treatment of inflammation of the middle ear, which has turned into a chronic form. The medicine is instilled in 2-3 drops three times a day. The total period for taking "Otofa" should not exceed one week.

Normax. An ear remedy with an antibiotic of the fluoroquinolone family, norfloxacin. This drug can be prescribed for external inflammation of the hearing organs, as well as acute and chronic forms. With a complex course of the disease, 1-2 drops are prescribed at intervals of two hours. For moderate and mild illness - 2 drops four times a day. The medicine is contraindicated in children under 15 years of age.

"Levomycetin alcohol". A solution of chloramphenicol is usually used in the treatment of purulent otitis media. You need to drip 1-3 drops per day, the introduction of cotton turundas, soaked in a solution, into a sore ear works well. Procedures with chloramphenicol alcohol can be performed daily, no more than seven days.

"Sofradex". The bactericidal preparation - aminoglycoside framycetin, which is in drops, acts very quickly and effectively for otitis externa. It is recommended to take it four times a day, 3 drops in the affected ear. You can also make cotton swabs with "Sofradex" on the affected area of the auricle. “Sofradex” should not be given to infants, children under 4 years of age should be given the drug with great care.

Other drops in the ear:

Otipax. Drops that perfectly relieve pain and reduce the spread of the inflammatory process. They are widely used for acute inflammation of the middle ear, for otitis media, which has become a complication of a viral disease (influenza, ARVI). The dosage is 2-4 drops four times a day. They can be used in the treatment of children of any age, starting from birth. The maximum period of taking the drug is 10 days.

Otinum. These are drops that act against inflammation. Their doctor will recommend children with diagnoses of otitis media and otitis externa. The dosage is 3-4 drops in a sore ear four times a day. The average course is from a week to 10 days. There is no age limit.

Ointments

Mild otitis media can be treated with ointments. Although more often this form of the drug is used not as a separate type of therapy, but as an excellent addition to other complex prescriptions of the doctor.

"Levomekol". Combined ointment containing an antibiotic and an anti-inflammatory drug. The ointment is “put” into the sore ear with a cotton swab or tampon. It is recommended to do this procedure 2-3 times per day.

"Flucinar". An ointment that does not contain antibiotics but has a strong anti-inflammatory effect. Turundas with such a drug can be injected into the ear several times a day. The ointment should not be given to children under the age of 2 years.

General recommendations

With a purulent form, do not warm up the ear. This will provoke a more rapid multiplication of pathogenic bacteria.
You can not independently change the dosage of the drug and the duration of the course of antibiotic treatment. With otitis media, the average course is usually 5-7 days.
The effectiveness of the antibiotic must be evaluated within 2-3 days after the start of its administration. Usually 72 hours is enough to understand if the child has felt better. If not, you need to replace the antibiotic with another. This can only be done by a doctor.
When instilling drops in sore ears, make sure that the medicine is slightly above room temperature (just warm the bottle in your hand), it is advisable to first clean the auricle of sulfur and purulent discharge. A solution of furacilin is suitable for this.
Keep track of the expiration dates of medicines in your home medicine cabinet. Remember that drops and ointments have a shorter shelf life than tablets and capsules. And the finished antibiotic suspension cannot be stored for more than 14-24 days.

Children's doctor Yevgeny Komarovsky, beloved and respected by mothers, is sure that there are no alternatives to antibiotics in the treatment of otitis media yet. But he is in favor of applying European practice. In many countries, children are vaccinated after birth against staphylococcal and hemophilic infections, and the incidence of otitis media and other ENT diseases in children in the UK, France and Germany has been reduced several times in recent years. In Russia and the countries of the former CIS, they have not yet been vaccinated against Haemophilus influenzae and staphylococcus. The doctor hopes that such vaccination will eventually become part of the Russian national immunization schedule.

In the following video, Elena Malysheva and her colleagues will talk about the symptoms of otitis media and the methods of treating this unpleasant disease.