• Knowledgebase: Cough, Congestion, and Ears

    Questions about the managment of coughs and congestion, as well as ear infections.

    5. My child keeps getting ear infections - Top

    Ear infections (middle ear infections or otitis media) make up 50% of the problems seen be pediatricians in the winter. Middle ear infections are generally caused by swelling and blockage of the eustachian tube (which drains the middle ear). This then is followed by fluid accumulation in the middle ear which then becomes infected. This process is usually set off by nasal congestion. These infections usually are associated with pain and fever but they can occur without these symptoms.

    Some children are more prone to otitis media then others. Children with allergies have more problems as well as children whose parents had problems with ear infections. Also, children with cigarette smoking in their environment have more ear infections.

    Treatment for otitis media needs to accomplish two things: clearing of the infection and drainage of the fluid or pus. We have antibiotics far the first but we have not found any medication that successfully accomplishes drainage. Generally, the body will open up the eustachian tube and facilitate drainage, but sometimes this does not happen. Studies have shown that when fluid or infection persists in the middle ear for 3 months or greater without any clear periods, hearing loss can result. Because this is due to our inability to drain out the fluid, we treat this chronic otitis media with surgical drainage and the placement of noncollapsible tubes to maintain a drainage system. For children who have recurrent ear infections but clear in between, a consideration is to place them on long term preventative therapy with antibiotics at low doses daily. This is done less commonly now than in the previous decade.

    The pneumococcal vaccine (Prevnar) is another option that may cut a child’s risk for otitis media by 25%.

    Ear infections are frustrating for parents and physicians. The long term care and followup is very important in order to prevent hearing loss.
    - Updated: March 22, 2001

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    • James L Horwitz, MD

    David C. Thomas, MD

    Barbara Lindberg, PNP