Acute Otitis Media

Otitis (inflammation) media (middle ear) refers to an infection of the middle ear compartment. If the symptoms are less than one month in duration, it is known as acute otitis media. Children are more susceptible to this condition because of a few reasons;

  1. the Eustachian tube leading from the nose to the middle ear is less mature and does not protect the middle ear as well as in adults
  2. Many children have large adenoids which affects the function of the Eustachian tube. Large adenoids also predispose children to sinusitis which in turn increases the likelihood of getting otitis media
  3. Young children’s immunity is not mature till they are about 12 years old. Lower immunity makes them susceptible to infection, including otitis media

Symptoms

  1. Sudden onset of ear pain. It can be so severe to affect sleep, alertness, mood
  2. Fever
  3. Hearing loss
  4. Ear discharge – usually a late symptom. When the infection is not treated adequately or promptly, the infection can burst through the eardrum and cause discharge from the ear. This usually is accompanied by relief of ear pain and resolution of fever.

Treatment

Since the symptoms are acute, treatment is urgent and aimed at symptom relief and control of infection

  1. Oral antibiotics – first line antibiotic is usually a penicillin eg. Augmentin or macrolide eg Klacid. The maximum allowance dose according to weight should be used and for a minimum of ten days (usually 2 weeks is recommended). Uncommonly, intravenously antibiotics are required.
  2. Oral Pain Relief – Paracetamol, Ibuprofen or Neurofen are frequently used
  3. Ear toilet and eardrops – only required if there is discharge from the ear
  4. Myringotomy – this is a minor procedure involving making a small cut in the eardrum to release the infection. Usually considered if one week of maximal medical therapy does not result in improvement or if symptoms worsen.