Tuesday, March 3, 2009

Ear infections-- drugs

Sorry for infrequent blogging, evidently when I say tomorrow, I actually mean next week. I blog at work if not too busy, and lately it's been so busy I don't eat. Trying to blog at home is too much of a headache for me with children, hats off to all of you who accomplish that feat. On to ear infectons.

There are three major organisms that can cause ear infection. We usually start with high dose Amoxicillin for ear infections. Sometimes the bacteria have mechanisms in place to defend against the antibiotics we give. Augmentin, which is usually the next step, is amoxicillin plus a drug to fight the bacteria's defense mechanism. Omnicef, which is often the third choice, is a broad spectrum antibiotic. It's like a big missile that wipes out everything in its path. Amoxicillin is not a weak antibiotic anymore then Omnicef is a strong antibiotic. Amoxicillin is a great drug, but more specific like a precision missile that only wipes out a few buildings instead of a whole block. Any antibiotic can cause diarrhea and these often do. Taking some probiotics like lactobacillus when on antibiotics can help. Usually if your child has not been on any antibiotics for at least 2 months we start with amoxicillin again. The bacteria usually have to be exposed to the drug to be resistant to it. We want to use the antibiotic with the most narrow spectrum to cover the infection, because if we keep giving the broad spectrum drugs and your child's infection become resistant to that drug, there are fewer antibiotic choices left and a higher likelihood that your child could have complications with other resistant bacteria. Some children do seem to be colonized with resistant bacteria for whom amoxicillin no longer is effective, but for the most part always start with amoxicillin, excepting of course those who are penicillin allergic.


jenimur said...

I appreciate the info! Keep it coming at any interval that works! Thanks!

Meredith said...

I love getting a chance to read your blog! We just went thru a kidney infection with my 9 mo old and they immediately put her on omnicef for 10 days then a low dose nitrofurat, I think it is called, the label is messed up, anyway, until further tests determined if she had reflux. (She doesn't.) Having my daughter on antibiotics for 3+ weeks kinda freaked me out because I am fully of the opinion that antibiotics are saved for the real deal true bacteria infections and most things, like the ear infections you cited, are viral. But I think I understand why we were on the second one, just in case. Anyway - thanks for the info about the antibiotics - I now have more insight and can ask better questions!