Ear infections are a secondary infection that usually occur after an upper respiratory tract infection ( runny nose, congestion and cough). Most often your child has been sick for a bit, starts to get better and then develops fever and stops eating or sleeping much. Fluid that has built up in the Eustachian tube gets secondarily infected. Recently there have been a lot of studies in Europe where they actually tap the infected ear and grow them out and they have found that especially in older children, the vast majority of unilateral ear infection without fever are viral. In the realm of 75-80% of them. In children older then 2 without fever and a one sided ear infection I give the parents a script for an antibiotic and tell them to wait a couple of days to see what happens. I recommend the parents continue to treat their child's pain with Tylenol and ibuprofen and I really like the benzacaine numbing drops. I even do this with my own children. I have looked in their ears and they have bad infection I given them pain meds and send them to bed and then they never complain about it again.
In children less then 2 I treat all infections.
More about ear infections tomorrow.