The most common ear infection in children is in the middle ear. Also called otitis media, these infections are the most common reason children are given antibiotics, according to the American Academy of Pediatrics. However, 90 percent of the time fluid is seen in the ear, it is not because of a true infection but because of a cold or recent bacterial infection and will resolve without antibiotics. For this reason, the approach for ear infection treatment has changed dramatically in recent years from "treat first with antibiotics" to what's called the "wait and see approach."
Antibiotics First Plan
Antibiotics are administered to children under 6 months of age with ear infections when there is a perforation in the ear membrane or if the wait and see plan has failed. The antibiotic given most often is amoxicillin. Other antibiotics are given if a child is allergic to amoxicillin, has a history of amoxicillin not working or if the clinical situation dictates a specific antibiotic.
The Wait and See Plan
For children over 6 months of age, the wait and see plan is the standard of care today. For these children, pain is controlled with oral doses of acetaminophen or ibuprofen and numbing ear drops are placed in the painful ear. If after two to three days, the pain has not resolved or is getting worse, an antibiotic, typically amoxicillin, will be considered, typically after a re-examination of the ear.
Other Reasons for Antibiotics
Sometimes it is not the middle ear that is infected but the ear canal. In this situation, antibiotic ear drops are prescribed for all children. These ear infections are also called swimmer's ear or otitis externa. There are a number of common antibiotic ear drops used for this condition, some of which include Floxin drops, Cipro drops and Cortisporin drops.
