Doctor and mother of twins Barbara Barnett with some tips about when to call your doctor about a suspected ear infection.
by Barbara Barnett, M.D.
One of the toughest questions for me to answer is how parents know when to take their children to the doctor. If you wait too long, the window for precious treatment time is lost. However, if the child presents too early, an accurate diagnosis may be difficult.
Consider, for example, acute otitis media, better known as an ear infection.
Ear infections are the most common bacterial illness in children — over 5 million cases of acute otitis media occur each year, with 10 million antibiotic prescriptions and about 30 million annual visits to the doctor’s office. Fifty percent of antibiotic prescriptions for preschoolers in the U.S. are prescribed for ear infections. (F.Y.I. The average preschooler carries around 1 to 2 pounds of bacteria! These bacteria have had 3.5 billion years of experience resisting and surviving environment.)
An acute otitis media infection usually has an abrupt onset of illness. Middle ear fluid collects, and then the signs of a middle ear inflammation begin. The most common symptoms of an ear infection include fussiness, fever, pulling/rubbing at the ears, or changes in sleep or appetite.
New guidelines suggest starting antibiotic treatment only if symptoms do not improve within 48 to 72 hours. Surprisingly, 80 percent of children with acute otitis media do get better without antibiotics!
And for those children who do end up needing antibiotics, about 15 percent suffer from diarrhea or vomiting, and up to 5 percent have allergic reactions.
So don’t be surprised if your children’s doctor recommends “watchful waiting” for 48-72 hours. Fortunately, after 24 hours of watchful waiting about 60 percent of children feel better.
When in doubt, however, it’s always best just to go ahead and call your doctor.