When antibiotics are given for ear infection

[ClaireJDOJ]

Hi all,

I know this sounds like a really dumb question but just wanting other experiences. I took my twins (16mo) to the doctor over the weekend because one of them had a high fever that I couldn’t bring down and they were both pawing at their ears.

The doctor had a look at said that both ears of both twins were extremely inflamed and prescribed antibiotics. A couple of days later one of them has a post viral rash (confirmed by another doctor) so I’m assuming their ear infections are also caused by the same virus in which case the antibiotics won’t be doing anything, right? Or are there secondary type bacterial infections caused by viruses that antibiotics can help?

Pretty sure they are probably on antibiotics for no reason although I’m obviously not going to stop them finishing the course I’m just genuinely curious about the decisions the doctors make about ear infections.

Our trip to the doctor was pretty stressful as both twins were hysterical so I didn’t get to ask many questions such as what factors made him prescribe antibiotics. High fever? Obvious pain?

Any other parents who have been in a similar boat and know much about this topic?

Many antibiotics cause a rash in the third day . 10% of kids who take amoxicillin (augmentin) develop a rash. So given how hard it is to differentiate a viral rash vs antibiotic rash, I would be more propense to think it is a antibiotic rash.

Antibiotics can cause so many different types of skin reaction
dermnetnz.org/topics/cutaneous-adverse-reactions-to-antibiotics/

As a very crude rule of thumb, if they have cold symptoms as well, or if both ears are affected, it's much more likely to be viral. No cold symptoms and only one ear affected, much more likely to be bacterial. But it does also depend upon what it looks like in there.

Thanks guys. Yeah I’m just feeling a bit crap about the fact that they are taking antibiotics when they probably don’t need them

@ClaireJDOJ don't assume they didn't need it . You can have both a viral and bacterial infection, and the virus starts it but then bacteria follows.

www.dukehealth.org/blog/it-bacterial-infection-or-virus
"Bacterial infections may be the result of "secondary infection" (meaning that the virus initiated the process but a bacteria followed) when the:
Symptoms persist longer than the expected 10-14 days a virus tends to last
Fever is higher than one might typically expect from a virus
Fever gets worse a few days into the illness rather than improving
Sinusitis, ear infections, and pneumonias are common examples of secondary infections .

@Cormoran thank you this makes sense to me!

I started spiralling and reading too much in to the scaremongering surrounding giving antibiotics on the internet (I know, it’s a slippery slope). Being a parent is hard when you’re constantly being made to second guess the decisions you make about your kids.

It is understandable, but I think you are focusing too much on the wrong culprit.
What will be determinant in your kids' healthy microbiome is not the occasional antibiotics but their daily diet, in other words what they put in their mouth from the moment they wake to when they go to bed.
And this is where you have a TOTAL control at their age.
Do they have breakfast cereal? Industrial toast? snacks such a rice-cakes, cereal bar, melty puff, crisps? Processed meat or cheese (spreadable or square under plastic) .
How much and how many different vegetables they eat per day / week, only the same old tree carrot-cucumber-cherry tomato or are they adventurous with artichokes, leeks, fennel?
Do they eat lentils and chickpeas (not the industrial hummus) .
Do you cook fresh or are a significant part of the food manufactured in a factory?

Watch Erica Sonnenburg , the author of several books on the microbiome

Useless antibiotics is an issue, but you need to be aware that the vast majority of AB is used in the cattle , swine , fish industry ( 66 vs 44%) to prevent infection because the animals are raised standing / swimming in their own "crap" , surrounded by liquified faeces and sick animals.

Your concern has ground, but I hope I have provided some clarity on priorities. An ear infection is very painful, an AB gives relief.
But pursue your interest in the gut microbiome and make the right changes for your kids - unless already eating a gut friendly diet.

Trust the science and your doctors more than social media.
I hope your littles ones get better soon.

Antibiotics don't work against viruses for a start off.

Ear infections the best antibiotic can vary. Ds had them regularly, about 3 times a month from 10 weeks old. If his ear drum burst they'd often take a swab and choose the right antibiotic accordingly. We sometimes had a call to swap antibiotics if they decided there was a better one or, on one occasion, when he had an antibiotic resistant one.

Generally they choose not to give antibiotics for ear infections as it's more often viral. However ds seemed to get bacterial ones for some reason-if he gets antibiotics within the first few hours of pain, the ear infection generally goes fairly quickly. If he doesn't his ear drum will burst within 24-48 hours.

Sorry, I see you'd realised the first sentence.

What I found was ds used to get viral rashes, but bacterial ear infections. Sometimes concurrently, which was fun, especially when they were non-fading rashes. Try a& e for blood tests with a toddler with ear infections.

You need to finish the antibiotics anyway, even if you think they aren't helping.
What I used to reckon was there was some improvement within 48 hours of starting the antibiotics or he needed to be seen again. Sometimes it was that it was viral (although unusual with him) and sometimes they needed to take a swab to work out what antibiotic would work. Swab is fairly easy to do.