Antibiotics for possible ear infection in 2 year old?

[osterleymama]

My DS (two next week) had loads of brown waxy gunk coming out of his ear for about two days after a short-haul flight. He's been a bit cranky, smaller appetite than usual and a very slight temperature two days ago. He's also been waking up at night since we got back (he'd had a week with my family without DP and I think his night-waking and clingyness could be party down to this - he's all about Daddy this week!).

Took him to GP who looked at his ears and said there was too much wax to see if the ear was inflamed/infected but that based on what I'd told her it was likely and gave me a prescription for 5 days of antibiotics.

I'm not sure it's in his best interests to give it to him for a slight ear infection, I've read it can lead to young kids becoming less responsive to antibiotics ni the future when they might really need them. I've also read that ear infections clear up in a few days alone, but never dealt with one before. Any advice gratefully received.

Brown wax just usually means it has been in the ear for a while. My DD produces tons of the stuff and it blocks her ears constantly. Flight might have played havoc with the pressure in his inner ear and it can also drive any infection inwards. To be honest I would probably go with whatever the GP says and do the full course as more harm is done by cutting it short. I think we are all a bit more protective with our first child re: medicines and diet and worry a bit less second time around. Personally I don't think it will do him any harm, and could probably speed up his recovery. Then again you are his mum and you know best, go with your instinct.

I would read this here it covers ear infections in children. Antibiotics can have nasty side effects like diarrhoea and upset tummy and its often better to let the body fight infection so it builds up its defences against that particular bug. Often ear infections are caused by viruses anyway so dont respond to antiBs.

here is also a reliable source.

I think you can afford to wait and see how it goes provided your DS is realtively well. calpol and ibuprofen can be given together as earache is very painful. A warm pad on the ear is also useful. If you use the above sites as guidance you can allow yourself to trust your instinct backed up with evidence backed advice.

Actually as a result of my baby nearly dying due a terrible complication from an ear infection ENT surgeons now advise that children under 5 do get antibiotics for ear infections now. DDs ear infection started with brown gunk coming from her ear and two weeks later she was seriously ill in hospital. I was lucky DD was treated by one of the top paediatric ENT surgeons in the country and he performed a 1.5hour surgery that saved her life, but she now has hearing loss.

My baby was hospitalised for 5 days with an ear infection, it caused her temperature to spiral out of control and the doctors had difficulty bringing it down and were worried. Luckily, she was ok in the end, however it was very scary. Ear infections can sometimes turn nasty, I wouldn't risk not giving the prescribed antibiotics.

There are always horror stories of course but the vast majority of children are fine with mild ear infections.

The NICE guidelines (should be followed by GPs btw) I directed to are clear on this and also Patient UK uses valid research to base its answers on too.

A mildly unwell toddler with a 2 day history of ear problems will probably recover well (the vast majority do) but there will always be exceptions and unfortunately we dont have a crystal ball and neither does the GP so they often err on the side of caution. They should be following the NICE guidelines though. End of the day its up to each parent to regularly assess their own child on an hourly/daily basis. 2 weeks to leave a child untreated is way too long and if a child is worsening after 3 days regardless of having seen a dr earlier, I would take them back.

Children dont usually go from relatively well to deaths door with simple illnesses in a matter of hours, unless its something horrific like meningitis, so careful monitoring is essential.

Basically its all about common sense and making sure you have accurate evidence based research you are basing your decisions on.

I would say, as long as she doesn't have a high temperature, and you are happy with calpol/nurofen to ease any pain and discomfort, stick with that.

I little olive oil in the ears and resting head on a warm water bottle will ease out any gunk a bit quicker.

But if your dd got a high temperature or was very uncomfortable, I would be inclined to give her the antibiotics just to help her fight any initial infection.

All medicines have side effects one way or another, it's a bout measuring up the advantages an disadvantages. For me, a poorly, uncomfortable and sick child is avoidable, then I'd avoid. But feeling off for a day or two wouldn't warrant anti b's for me personally.

For you to judge as mum.

Your ds sorry....not dd

I have to disagree sneeze cakes the ENt surgeons are putting the case to nice about this my DD never ran a temperature and continued to smile a giggle throughout. If your GP is concerned enough to give antibiotics I would use them. NICE are slow to react to new clinical data, there are articles published about this. I was lucky as I said partly as a GP registrar had a bad feeling about DD and went against another doctors advice to get DD seen as an emergency by pads she was the first in what I know have been a steady flow of mastoid abscess. I have kept on contact with DD's surgeon he lectures GP registrars and he now always advises antibiotics due to this trend he is seeing.

Oh yes a mastoid abscess becomes mengitis hence the issue of short time mattering.

Thanks everyone. I started him on the antibiotics last night when his other ear started producing gunk and his temp raised again. Didn't want to risk it..

" Then again you are his mum and you know best, go with your instinct."

Such a scary silly thing to say!

Mild ear infections often do clear up on their own- I think antibiotics tend to shorten them by a day or so, which may or may not be worth it- if ibuprofen keeps the pain away it might be better not to give antibiotics if you can avoid it.

But it sounds as though things were getting worse not better in this case, so antibiotics were th way to go. Hope he's feeing better now.

Please do not take any chances with yor child, do not take medical advice from an Internet forum where no one can be held responsible for the consequences of their actions. GP's do not write prescriptions willy nilly so I would take their advice and not take chances with your child's health or hearing.

Interesting to know that ENT surgeons are advising abx in under 5s. Advice does change and as you say NICE can be a bit behind. I have worked in a GP s surgery and sometimes GPs do give out abx willy nilly, especially out of hours. Most are more responsible though. Mastoid abscesses are an uncommon complication of ear infections though but very serious.

OP it's the right thing to do as I advised. Fever increasing especially after 2-3 days is an indicator abx are needed. If the pain is especially severe local anaesthetic drops can be prescribed and the OOH dr would probably do a phone consult to save going to the clinic. I am sure in a few days he will be fine. If he is not picking up after 48 hours (it takes that time for abx to kick in) take him back. Obviously if you are worried at any time get medical advice. As nurses we were always told to trust the mothers instinct and as a mother I would agree.

Antibiotic over prescription is the cause of an increase in superbugs and there are are now bugs which have no reliable medications to fight them, which is a terrifying prospect for the future, hence tightening up on unnecessary usage.

My Grandparents were both GP's and openly admitted they were often shooting in the dark with pre-verbal children and so would medicate to err on the side of caution. My GP is a very nice woman but not always the most efficient doctor (she wasn't able to help with DS's eczema until I did my own research and asked for a specific treatment/got an initial private prescription from a derm, consultations are rushed, she relies on google quite a bit and prescribed me a week on daktacourt for a skin rash when I am pregnant). When she checked his ears she said she couldn't see an infection because his ears were waxy but it sounded like he probably did. This, to me, seemed a flimsy reason to prescribe antibiotics. I asked if I should perhaps clean his ears with a wax treatment or something else and she said no, just dose him with antibiotics.
I would not rely on an internet forum for medical advice but would happily canvas opinion from other parents, conduct my own research from reputable sources and take these things into account in addition to the opinion of one GP. I think this is more responsible than blindly following every piece of advice from a GP, I also think the person accountable for DS's wellbeing is ultimately me. If I did the wrong thing for his health because the doctor said so and I ignored my instincts I would be negligent.

Osterley. Bit shocked your GP googles stuff! Maybe rare chromosomal syndromes can be forgiven but rashes, pg women and ears are their bread and butter. As you say it's pre verbal children that can be difficult and it's acceptable to be cautious but vets also deal with non verbal mammals and seem to figure things out!

It's easy to worry about scare stories and parents and doctors will always make mistakes...it's life, but if you do your research and use common sense, your instincts are usually right. I remember a mum who came to a&e where I was working with one of her twin babies, straight from the OOH gp and within minutes the baby was on life support. Horrendous, but she trusted her instincts. Another horror story!! Sorry but it's not the only incident I could relate so carry on trusting yourself