For otitis, what antibiotic for a child?

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What antibiotics can be used for otitis in a child?

Otitis is an extremely unpleasant disease that can “knock” an adult out of the rhythm of life for quite a long time, let alone children.

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Unfortunately, children are the favorite “target” of this pathology due to numerous factors: from the structural features of the hearing organ to frequent respiratory diseases.

If parents suspect even the slightest hint of otitis in their child, they should immediately show him to an otolaryngologist, who will prescribe an effective treatment regimen, often including antibacterial drugs. Just within the framework of this article, we will touch upon an issue that worries many parents - the use of antibiotics for otitis media in children.

Pediatric otitis - characteristic features

Children's otitis is an inflammatory process of an acute or chronic nature that affects one of the parts of the hearing organ. Depending on the location of inflammation, the following types of otitis media are distinguished:

In addition, the inflammatory process, according to the nature of its spread, is divided into unilateral and bilateral.

The second type of illness is much less common.

Reference. It should be noted that the development of otitis media is often characteristic of childhood.

Inflammation of the middle ear is characterized by several stages:

  • Stage 1 - inflammation of the Eustachian tube occurs (tubo-otitis), as a result of which it does not perform the function of equalizing pressure. After the inflammation reaches the middle part of the ear cavity, the production of fluid - exudate - begins;

Reference. The disease at the initial stage of otitis media is called catarrhal, exudative or secretory otitis.

  • Stage 2 – purulent otitis media, in which infections occur and pus accumulates in the middle ear cavity. When a large amount of purulent masses accumulates, they begin to put pressure on the membrane of the eardrum, as a result of which it perforates and the pus comes out;
  • Stage 3 – the process of restoration of the eardrum membrane occurs, as well as the normalization of the auditory analyzer.

As for the factors that provoke the occurrence of otitis media in children, these include:

  1. Anatomical features of the Eustachian tube - up to a certain age, the auditory tube in a baby is much shorter and wider, and also does not have the characteristic slight curvature, as in adults. This phenomenon causes the unhindered penetration of pathogenic organisms into the ear.
  2. Frequent acute respiratory infections, acute respiratory viral infections, leading to complications in the form of otitis media.
  3. Pathologies of the nasopharynx of a chronic form, forming a constant source of infection in the immediate vicinity of the middle part of the hearing organ.

Having briefly familiarized ourselves with the features of the development of ear inflammation in childhood, let’s move on to the question of the need to use an antibiotic for children with otitis media.

Treatment of otitis in children with antibiotics - is this necessary?

The issue of using antibiotics for the treatment of childhood otitis has been discussed for quite a long time, not only among parents. This topic also causes heated debate among doctors themselves.

Often, parents resist with all their might giving their baby an antibacterial drug, questioning the doctor’s prescriptions and considering antibiotics to be a real “evil.” But is it?

Let's start with the fact that numerous studies by international medical organizations come down to the fact that there is still no need to rush into taking this group of drugs for childhood otitis.

The “wait-and-see” approach, which involves monitoring the baby for 2 days, is becoming increasingly popular among specialists. It is this period that is enough for the doctor to understand whether the child’s body can cope with the disease without serious medications or not. But this applies to moderate otitis media.

But this moment also has its own nuances. Such tactics are justified only if the child is over 2 years old or has suffered from catarrhal otitis without turning purulent.

Attention! For children under 2 years of age, antibiotics are prescribed without fail to avoid the dangerous consequences of otitis media.

At the same time, there are more specific symptoms in which the otolaryngologist decides to immediately use antibacterial medications. These include:

  • severe pain syndrome;
  • symptoms of intoxication on the face;
  • body temperature reaches 39°C.

Reference. Antibiotics for otitis media in children ensure the course of the disease without complications with complete preservation of hearing function.

Next, we will find out which antibiotics are prescribed to children for otitis, and which of them are the most effective and safe.

"Suprax"

Pediatric otolaryngology uses this drug in many cases of ear inflammation.

Thanks to its research-proven effectiveness and safety, it is in good standing with specialists.

"Suprax" is a third generation cephalosporin antibiotic. Characterized by a wide range of effects.

The nature of its action is bactericidal, that is, it destroys the synthesis of the cell wall of pathogenic microbes. Effective against both gram-positive and gram-negative bacteria.

It is produced in different forms: capsules and suspension. Accordingly, patients under 12 years of age are prescribed suspensions, and patients over 12 years of age are prescribed capsules.

The drug remains in the body for a long period, so it is taken once a day.

Reference. This medication should not be used by people with individual intolerance to the active ingredient or with renal failure.

"Sumamed"

"Sumamed" is an antibiotic - azalide, belonging to a new subgroup of macrolide antibacterial agents.

It has a wide area of ​​influence.

The active substance is azithromycin, which has a bactericidal effect when accumulated in high concentrations near the area of ​​localization of inflammation.

Available in tablet and powder form. Take once a day 1 hour before meals or 2 hours after.

“Sumamed” will remain in the body tissues directly at the site of inflammation for up to 7 days after the end of treatment, which makes it possible to manage with short courses of therapy (up to 5 days).

Reference. Contraindicated in patients with impaired liver and kidney function, as well as in case of individual intolerance to the components.

"Flemoxin Solutab"

"Flemoxin Solutab" is a penicillin medicine with a wide area of ​​action.

The active ingredient is amoxicillin, which is a semi-synthetic antibiotic.

The drug has a high degree of absorption and is resistant to acidic gastric juice.

This medication is the safest for children, as side effects are very rarely observed.

The drug is released in tablet form, which is especially noteworthy; they have a characteristic citrus flavor. Therefore, children will not have problems taking the drug. This antibiotic is used for otitis in children not only 5 years old, but also in children under 1 year old.

Reference. The main contraindication is hypersensitivity to the substance – penicillin.

"Augmentin"

It is a combination of the antibiotic amoxicillin and clavulanic acid.

Since penicillin was the first antibiotic developed, many pathogenic organisms have developed resistance to it.

That is why its combination with clavulanic acid has a destructive effect on the sustainable resistance of pathogenic microflora and provides a positive effect in the treatment of ear inflammation.

"Augmentin" is produced in the form of drops - for children under 1 year of age, a suspension, which is prescribed to children under 12 years of age, as well as tablets - for children over 12 years of age. Taken 3 times a day.

Reference. Use with caution in the presence of severe abnormalities in liver function. Sometimes individual intolerance to the components of the medication is noted.

"Klacid"

"Klacid" is a semi-synthetic antibacterial drug from the macrolide group.

The medication is one of the less toxic in its group and has a wide range of effects.

The drug is highly effective in the treatment of acute otitis media.

Allowed for use in children over 3 years of age. The course of treatment can last from 5 to 14 days.

The dosage is calculated by the doctor based on the age and weight of the small patient.

Reference. "Klacid" is contraindicated in patients with hypersensitivity to macrolide substances. Also, the drug cannot be taken simultaneously with certain medications.

In modern medicine, the antibacterial group of drugs is represented quite widely, and the list can be continued for many more points. However, the above medications are the most popular and safe for children from a very early age.

Whatever the safe drug, it is still better to trust a competent specialist when selecting medications for a sick child, since among this category there are drugs that are toxic to the child’s body.

Directory of main ENT diseases and their treatment

All information on the site is for informational purposes only and does not claim to be absolutely accurate from a medical point of view. Treatment must be carried out by a qualified doctor. By self-medicating you can harm yourself!

Source: http://gorlonos.com/ushi/otit/kakie-antibiotiki-ispolzovat-u-rebenka.html

7 popular antibiotics for otitis media in children

The term acute otitis media refers to an inflammatory process in the middle ear, most often associated with the action of a bacterial agent. Less commonly, inflammation is caused by viruses, fungi, an allergic or post-traumatic component.

The prevalence of the disease is associated with the anatomical features of the location of the Eustachian tube in children (more horizontally than in adults). This makes it easier for infection to penetrate from the nasal cavity or mouth into the middle ear cavity.

The high risk of intratemporal and intracranial complications forces doctors to prescribe antibiotics for otitis media in children immediately after diagnosis. This approach to treatment allows us to minimize the progression of the disease, reduce the incidence of severe complications and the possibility of irreversible hearing loss.

Main symptoms of the disease

The main difficulty is presented by children in the first years of life. The child cannot formulate symptoms or answer the doctor’s questions. In such a situation, parents should “sound the alarm” if the baby has had a fever for several days, but there are no visible catarrhal manifestations (cough, runny nose), or signs of intestinal infection (vomiting, diarrhea).

The baby behaves restlessly, refuses to eat, constantly tries to touch or scratch the sore ear, and does not place his head on the side of the inflammation. If otitis media has become a complication of another disease, the temperature may rise during recovery, or vice versa – there may be no dynamics from the treatment.

Older children may complain of ear pain, a feeling of fullness, fullness, and hearing loss.

In case of perforation of the eardrum, severe suppuration from the ear is observed.

Indications for emergency hospitalization

  1. If purulent-inflammatory processes in the middle ear cavity are suspected, all children under 1 year of age should be immediately hospitalized in the otolaryngology department. Patients from one to three years of age are sent to the hospital in case of recurrent disease.
  2. The appearance of swelling, redness of the skin and pain behind the ear, severe headache, high fever and other signs of mastoiditis or anthritis.
  3. Severe intoxication. The child refuses to eat, is lethargic, drowsy, lethargic; Nausea or vomiting may occur after eating.
  4. Suspicion of intracranial complications.
  5. Older patients are hospitalized in cases where outpatient treatment is ineffective and clinical symptoms continue to progress.

Antibiotics for otitis media in children

Systemic and local antimicrobial therapy is prescribed to eliminate the inflammatory process and the source of infection in the middle ear. As an addition to this treatment, the use of pediatric ear antibiotics in the form of drops is indicated.

Most often they use 7: Anauran or Otofa - for local use, as well as Suprax, Ceftriaxone, Augmentin, Amoxiclav, Amoxicillin - for systemic use.

Antibiotic drops

Otofa

The active component of the drops is the semisynthetic antibiotic Rifampicin, which has a bactericidal effect on pathogenic bacteria due to blocking the RNA polymerase of pathogens and suppressing synthesis in the microbial cell. The spectrum of activity covers representatives of gram-positive and gram-negative flora.

Due to the possible development of resistance to the drug, long-term use as monotherapy is not recommended.

The product has very low absorption and does not cause systemic allergic reactions.

Complications may include itching, rash, hyperemia of the skin and eardrum.

Not prescribed if there is an individual intolerance to the components of the drops. There are no age restrictions for use. That is, unlike Anauran, which is prescribed only from the age of six, these antibiotics for otitis media in children 4-5 years of age and younger can be used without the risk of systemic complications.

Before use, it is recommended to warm the product slightly (holding the bottle in your palms). For children, three drops are prescribed in the ear every twelve hours. The standard course of therapy is seven days.

Anauran

Combined drops that have analgesic and antibacterial effects due to the antibiotics included in the composition (polymyxin B - polypeptide, neomycin sulfate - aminoglycoside) and local anesthetic (lidocaine hydrochloride).

Depending on the severity of otitis, instill two or three drops every six or eight hours. The course of therapy is seven days. Longer use is not recommended due to the risk of superinfection and the possible nephrotoxic effect of neomycin.

Drops can only be prescribed to children over the age of six years.

Suprax for children

The active component of the drug is Cefixime. This is a semi-synthetic antibiotic of the 3rd generation of oral cephalosporins. Suprax has a pronounced bactericidal effect on most representatives of gram+ and gram-flora. Does not affect staphylococci and some streptococci.

It is resistant to the action of bacterial beta-lactamases. The mechanism of influence on pathogenic microorganisms is due to the suppression of the process of synthesizing the structural components of the bacterial cell, which leads to its death.

  • for babies up to six months;
  • in patients with a history of antibiotic-associated diarrhea and pseudomembranous colitis;
  • in the presence of severe renal or liver failure;
  • patients with individual intolerance and allergic reactions to beta-lactams.

Children over 12 years of age who weigh more than fifty kilograms are recommended to take two hundred milligrams of Suprax every 12 hours. For patients weighing less than 50 kg, the drug is prescribed at a rate of 3 to 9 mg/kg; in case of severe disease, the dose can be increased to twelve mg/kg. The resulting dosage is divided into two or three doses.

From six months to twelve years, a suspension of 4 mg/kg is used twice a day.

Five milliliters of suspension contains 100 mg of Cefixime. The approximate dose of Suprax for children aged five to eleven years is 6-10 ml. From two to four years old, 5 ml is prescribed. From six months to one year, 2.5 - 4 ml.

Suprax Solutab is only suitable for adults or children over 12 years of age.

The course of treatment ranges from seven to ten days.

In severe cases of the disease, a course of injectable cephalosporins – Ceftriaxone – is recommended.

Side effect of the drug

  • allergies (local or systemic);
  • interstitial nephritis and renal dysfunction of varying severity;
  • dizziness;
  • antibiotic-associated diarrhea;
  • pseudomembranous colitis;
  • dyspeptic disorders;
  • hematopoietic disorder;
  • transient increase in liver transaminase levels;
  • dysbacteriosis;
  • candidiasis.

Augmentin for otitis in a child

The drug belongs to the semi-synthetic protected penicillins.

The active ingredient of Augmentin is Amoxicillin, protected by clavulanic acid. It has a bactericidal effect on pathogenic microorganisms due to the active inhibition of synthesis processes of bacterial wall components.

The combination with clavulanic acid helps to expand the spectrum of activity of Amoxicillin, due to the prevention of enzymatic destruction of the antibiotic by beta-lactamases.

Amoxicillin dosage calculation

For patients over twelve years of age, 250 mg every eight hours is recommended. That is, one 375 mg tablet containing 250 mg of amoxicillin and 125 mg of clavulanic acid.

For young children, the drug is prescribed in the form of a suspension or syrup.

Between the ages of seven and 12 years, 250 mg is used every eight hours. From seven to two years, 125 mg. From nine months to two years they drink 62.5 mg.

Contraindications for use are:

  • Русский
  • history of allergies to penicillins or cephalosporins;
  • antibiotic-associated diarrhea or pseudomembranous colitis associated with penicillin use;
  • severe renal or liver failure;
  • Epstein-Barr viral or cytomegalovirus infection.

Side effects

  • Русский
  • frequent allergic reactions and dyspeptic disorders;
  • colitis associated with antibiotic use;
  • intestinal dysbiosis;
  • thrush;
  • transient increase in liver transaminases, jaundice, hepatitis;
  • with prolonged use, superinfection may develop.

Amoxiclav

It is a drug similar to Augmentin, combining amoxicillin and clavulanic acid.

Antibiotics have the same composition, mechanism of action on pathogenic microorganisms, and a list of indications and contraindications. Dosage calculations are also carried out similarly (for amoxicillin).

Amoxicillin

It is a representative of broad-spectrum semi-synthetic penicillins. It is active against representatives of gram+ and gram-flora, but is not effective against strains capable of producing beta-lactamases. For otitis in children it is rarely prescribed, only for mild forms.

The mechanism of action is due to the inhibition of microbial cell synthesis of peptidoglycan, which is a supporting component of the bacterial wall. As a result, the pathogenic organism undergoes lysis and dies.

For children over the age of ten years and weighing more than forty kilograms, the drug is prescribed 500 mg three times a day. For younger patients, it is preferable to use suspensions. From five to 10 years, 0.25 grams are prescribed, from 2 to 5 years, 0.125 grams. Children under two years old are given 20 mg/kg every eight hours.

Additional treatments

The use of endoural microcompresses according to Tsitovich with an alcohol-glycerin mixture is effective (a 3% alcohol solution of boric acid and glycerin are mixed in equal parts). In severe and moderate cases, catheterization of the auditory tube is used, with further administration of antibacterial agents, and transtemporal administration of drugs is also possible.

A mandatory component of treatment is the use of combined drops into the nasal passages. The prescribed agent must have vasoconstrictor, anti-edematous and anti-inflammatory properties. The use of physiotherapeutic procedures (UHF, darsonvalization, electrophoresis with medicinal substances) is also effective. This therapy is indicated in the reparative phase, in order to accelerate the healing of the eardrum defect.

If conservative methods are ineffective, surgical treatment is used.

Perform paracentesis of the tympanic membrane, anthropuncture, or, if complications develop, anthrotomy.

The article was prepared by an infectious disease doctor

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Antibiotics for otitis media in children

Ear inflammation is a very unpleasant and rather dangerous disease that every child has suffered from at least once in their life. According to medical statistics, otitis is in fourth place in terms of frequency of occurrence. Before them are only viral infections (flu and ARVI), and ENT diseases - bronchitis and tonsillitis.

Pediatricians state that during epidemic seasons, every fifth small Russian suffers from otitis media. Children of any age are at risk, but children under 3 years of age are most susceptible to the disease. This is dictated by the structural features of the child’s ear (incomplete formation of the ear canal) and the “looseness” of the mucous membranes in childhood.

Most parents are interested in whether antibiotics are needed in the treatment of otitis media or whether they can be dispensed with. There is no clear answer. It all depends on what kind of otitis media your baby has.

Otitis can be external, middle and localized in the inner ear. And their stages vary from mild and moderate to acute and catarrhal. It is precisely depending on the stage of the disease that the question of prescribing an antibiotic to the child will be decided.

The symptoms of otitis media are not difficult to recognize. The child complains of shooting or sharp pain in the ear and headache. The baby's temperature may rise, hearing may decrease, and with purulent otitis media, a specific fluid mixed with pus is released from the auricle.

A mobile and active toddler becomes lethargic, painful, drowsy and moody, and loses his appetite.

Are antibiotics needed?

It should be noted that only 10-11% of children with otitis media require antibacterial therapy. This mainly applies to cases of purulent otitis media. If you notice symptoms of otitis media, do not decide on treatment yourself; take your child to the doctor. If, upon examination, the doctor does not find signs of the presence of a virus in the body (runny nose, high temperature, dry cough, etc.), then he may assume otitis media of bacterial etiology in the child. And then the question of taking antibiotic drugs will definitely arise.

In the next video, Dr. Komarovsky will tell you when it is necessary to use antibiotics to treat otitis media.

When are antimicrobial agents not needed?

  • Children who have crossed the age limit of 2 years with mild to moderate severity of otitis. For the first two days, the doctor will try to treat otitis media using alternative methods - he will recommend painkillers (Panadol, Nurofen, etc.), vasoconstrictor nasal drops, and will also tell you how to make a warm alcohol compress. In a couple of days it will become obvious where to move next. If the baby’s immune system copes with the infection, the symptoms of otitis media will ease. If not, you should think about antibiotics.
  • Children whose otitis media has become a complication of a viral infection (influenza or ARVI). Everything is quite simple here. Antibiotics are only effective against bacteria. Viruses are beyond their control. An antibiotic will not help, but it can harm the child.
  • Children over 2 years of age who do not have a fever and have moderate ear pain also do not need an antibiotic, so as not to have an immunosuppressive effect on the growing body. In other words, such a baby can easily cope with the infection himself with the help of his own defense system.

Indications for use

  • In cases where otitis media is diagnosed in a newborn and a child under 2 years of age.
  • If the baby’s body temperature rises above 39 degrees and lasts for more than 2 days.
  • When a visual examination confirms the presence of pus in the ear.
  • If the baby shows visible signs of severe intoxication.

The most common “culprits” of otitis in childhood are staphylococcus and hemophilus influenzae, known to everyone from the school biology course. Antibiotics of the penicillin family, as recent medical studies have shown, are, alas, ineffective against pests that cause ear inflammation. However, they can cure mild forms of the disease. In addition, relatively “soft” and “delicate” penicillin drugs will be an excellent start in therapy. If there is no relief after a couple of days, the pediatrician or ENT doctor will change the antibiotic to another.

To treat the acute form of the disease and catarrhal otitis, cephalosporin-type antibiotics and macrolides are usually used. They are more powerful; most bacteria have nothing to oppose them. However, the list of side effects and contraindications for such drugs is much wider.

The form of the antibiotic also matters. Syrups, tablets and suspensions can be taken to treat ear inflammation. But at a complex stage of the disease, for example, with purulent otitis media, doctors prefer to prescribe injections.

List of antibiotics

  • "Amoxicillin." An antibiotic of the penicillin group, which is widely used in the treatment of acute otitis media. Newborns and children under 5 years of age are advised to take an antibiotic in an easy-to-take suspension form. From 7 years old - in tablets, for teenagers from 12 years old - in capsules.
  • Unidox Solutab. An antibiotic drug is tetracycline, which helps in the treatment of all forms of otitis media. In pharmacies it is sold in the form of dissolving tablets. The medicine is not prescribed to children under 8 years of age. In general, pediatricians “dislike” tetracyclines due to the abundance of side effects they have.
  • "Augmentin". This penicillin drug has proven itself as a treatment for otitis media. To treat otitis media, increased dosages of this antibiotic are used. For children, a suspension form is suitable, which can be prepared from granules purchased at the pharmacy. For children of senior school age - tablets. A doctor can also prescribe Augmentin by injection to a patient of any age if he deems it necessary.
  • "Clarithromycin." The antibiotic is a semi-synthetic macrolide. Doctors prescribe this drug for various forms of otitis media. For children over 6-7 years of age, the drug can be given in tablets, after 12 years - in capsules. There is no other form of release of Clarithromycin. The doctor calculates the pediatric dosage of the antibiotic, taking into account the age and weight of the child, as well as the stage and characteristics of the disease.
  • Azithromycin. A macrolide antibiotic, which is often prescribed to children for inflammation of the middle ear and exacerbations of a chronic disease. It is available in capsules and tablets. Not recommended for children under 12 years of age.
  • "Sumamed." This antibiotic of the macrolide-azalide group is also a fairly common treatment for inflamed middle ear. The medicine is prescribed if the child is already 6 months old. The antibiotic can be used in suspension, in tablet form or in capsules. Sometimes doctors recommend Sumamed in injections.
  • "Suprax". A cephalosporin antibacterial agent is prescribed in capsules or suspensions for the treatment of otitis media, mainly acute or moderate forms of the disease, in children from birth. However, up to six months, the medicine should be given with extreme caution, preferably in a hospital under the supervision of specialists.
  • "Klacid." A fairly well-known antibiotic of the macrolide family. It is often recommended in the treatment of all forms of inflammation of the hearing organs. Existing pharmaceutical forms of the antibiotic give freedom of action to both doctors and parents. The drug can be given to a child in the form of a suspension, in tablets, or injected intramuscularly or intravenously. The doctor calculates the dose, and he also decides on the advisability of prescribing Klacida to children under 1 year of age.
  • "Ceftriaxone". Antibiotic of the third generation cephalosporin group. The drug is relevant for complex forms of the disease, when immediate antibacterial therapy is required. For complicated purulent otitis media, the medicine will be prescribed in the form of injections. The drug is given to children from birth with strict adherence to the dosage regimen.
  • "Cefazolin". First generation cephalosporin. It is available only in the form of powders for the preparation of injections, and therefore the doctor can prescribe it to a child if the otitis media is advanced or purulent, as well as in cases of severe other forms of the disease. The medicine is prescribed to children from 1 month of life.
  • "Cefipime." A fourth generation cephalosporin antibiotic is prescribed in exceptional cases. If otitis media is severe and other antibiotics have not helped. The only form of release is a dry substance for the subsequent preparation of infusions (injections). This is a strong antibiotic with a long list of side effects. For newborns and infants, the drug is usually administered in a hospital under 24-hour medical supervision.
  • "Cefuroxime Axetil." The second generation cephalosporin has proven itself in the treatment of ENT diseases, including otitis media. It is commercially available in two forms: dry substance for injection and tablets. The medicine can be used in newborns and children under 1 year of age (in injections). Children starting from 5-6 years old are allowed to take the tablet form of the drug.
  • "Omnicef." This is a drug of the third generation cephalosporin group, which is prescribed for most forms of otitis. The medicine on the shelves of pharmacists exists in the form of a dry substance for subsequent dilution for injection and in tablets. The drug is contraindicated for babies under six months of age.

Ear drops

If otitis is relatively mild, you can do without injections and suspensions. Local antibiotics will help. In complex forms of the disease, as well as in cases of intense, severe ear pain, drops can be a good addition to the main treatment prescribed by the doctor. When it comes to antibiotics, the following drugs are usually prescribed:

  • "Candibiotic." This is a combination medicine that contains an antibiotic (chloramphenicol) and a hormone. The medicine significantly alleviates the baby’s condition with acute external inflammation, with inflammation of the middle ear, and also with exacerbation of the manifestations of a chronic illness. The drug is dripped into the ears 4-5 drops four times a day. The average course of therapy is from a week to ten days. Manufacturers do not recommend using Candibiotic for children under six years of age.
  • "Drops "Anauran". The solution contains two antibiotics, as well as lidocaine, which quickly relieves severe pain. This medicine is recommended for instillation in acute inflammation and chronic illness of the external ear, as well as the acute stage of otitis media. The solution is injected into the auricle with a special dispensing pipette four times a day, two or three drops into the sore ear. It is not recommended to use Anauran for more than a week. If the child is not yet 1 year old, the drops should be used with extreme caution to avoid the development of an allergic reaction.
  • "Otofa." Antibiotic drops without admixtures of other components. It is based on rifamycin, a fairly effective antibiotic. The solution helps with inflammation of the outer ear; it is also prescribed to children if they are diagnosed with an acute form of inflammation of the middle ear, with a chronic illness, even with damage to the membrane. In addition, the remedy has shown its best performance in the treatment of inflammation of the middle ear that has become chronic. The medicine is instilled 2-3 drops three times a day. The total period of taking Otofa should not exceed one week.
  • "Normax". Ear remedy with fluoroquinolone antibiotic norfloxacin. This drug can be prescribed for external inflammation of the hearing organs, as well as acute and chronic forms. In case of a complex course of the disease, 1-2 drops are prescribed at intervals of two hours. For moderate and mild illness - 2 drops four times a day. The medicine is contraindicated in children under 15 years of age.
  • "Levomycetin alcohol." A solution of chloramphenicol is usually used in the treatment of purulent otitis media. You need to drip 1-3 drops per day; inserting cotton wool soaked in the solution into the sore ear works well. Procedures with chloramphenicol alcohol can be carried out daily, for no more than seven days.
  • "Sofradex". The bactericidal drug - aminoglycoside framycetin, found in drops, acts very quickly and effectively against external otitis. It is recommended to take it four times a day, 3 drops in the affected ear. You can also make cotton pads with Sofradex on the affected area of ​​the auricle. Sofradex should not be given to infants; children under 4 years of age should be given the drug with great caution.
  • "Otipax". Drops that provide excellent pain relief and reduce the spread of the inflammatory process. They are widely used for acute inflammation of the middle ear, for otitis media, which has become a complication of a viral disease (influenza, ARVI). Dosage – 2-4 drops four times a day. They can be used in the treatment of children of any age, starting from birth. The maximum duration of taking the drug is 10 days.
  • "Otinum." These are drops that act against inflammation. The doctor will recommend them for children diagnosed with otitis media and otitis externa. The dosage is 3-4 drops into the sore ear four times a day. The average course is from a week to 10 days. There are no age restrictions.

Mild otitis media can be cured by using ointments. Although more often this form of the drug is used not as a separate type of therapy, but as an excellent addition to other complex doctor’s prescriptions.

  • "Levomekol". Combined ointment containing an antibiotic and anti-inflammatory drug. The ointment is “put” into the sore ear using a cotton swab or swab. It is recommended to do this procedure 2-3 times a day.
  • "Flucinar." An ointment that does not contain antibiotics, but has a strong anti-inflammatory effect. Turundas with this drug can be injected into the ear several times a day. The ointment should not be given to children under 2 years of age.

General recommendations

  • If the form is purulent, do not warm the ear. This will provoke faster proliferation of pathogenic bacteria.
  • You cannot change the dosage of the medicine and the duration of the course of antibiotic treatment on your own. For otitis media, the average course is usually 5-7 days.
  • The effectiveness of the antibiotic should be assessed within 2-3 days after starting it. Usually 72 hours is enough to understand whether the child feels better. If not, you need to replace the antibiotic with another one. Only a doctor can do this.
  • When instilling drops into sore ears, make sure that the medicine is slightly above room temperature (just warm the bottle in your hand); it is advisable to first clean the auricle of wax and purulent discharge. A solution of furatsilin is suitable for this.
  • Keep an eye on the expiration dates of medications in your home medicine cabinet. Remember that drops and ointments have a shorter shelf life than tablets and capsules. And the finished antibiotic suspension cannot be stored for longer.

Beloved and respected by mothers, children's doctor Evgeniy Komarovsky is sure that there are no alternatives to antibiotics in the treatment of otitis media. But he advocates the use of European practices. In many countries, after birth, children are vaccinated against staphylococcal and hemophilus influenzae infections, and the incidence of otitis and other ENT diseases in children in the UK, France and Germany has been reduced several times in recent years. In Russia and the countries of the former CIS they do not yet vaccinate against Haemophilus influenzae and staphylococcus. The doctor hopes that such vaccination will eventually be included in the Russian national vaccination calendar.

In the next video, Elena Malysheva and her colleagues will talk about the symptoms of otitis media and methods of treating this unpleasant disease.

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Source: http://www.o-krohe.ru/antibiotiki/pri-otite/

How to treat otitis in children with antibiotics: review of drugs, dosage, reviews

Children have a special ear structure. Therefore, otitis media appears more often than in adults. A common runny nose can become a trigger for the development of the disease. Almost all children under three years of age have had otitis media. If left untreated, the consequences are very serious, including hearing loss. Therefore, parents should not only know the signs of the disease, but also the basics of proper treatment.

It can be acute or chronic. Depending on the location of the source of infection, it is divided into external, middle and internal. The bilateral form develops less frequently in children, but most often otitis media develops during the period from infancy to school age.

The disease occurs in several stages:

  • First. Inflammation of the auditory tube occurs. This leads to disruption of pressure regulation in the tympanic cavity.
  • Second. The formation of pus occurs. When its quantity increases, the eardrum bursts. If this does not happen, the doctor punctures it to drain the pus.
  • Third. The eardrum is restored and the functions of the middle ear are completely restored.

Causes

Among the reasons for the development of the external form are infections of the hair follicles. This can develop against the background of abrasions and scratches, and suppuration. Otitis media is often a complication after ARVI, childhood infections, adenoids, rhinitis, pharyngitis and others. On the external meatus, the disease can develop due to injury to the eardrum.

Causes of otitis media in children and its treatment:

Let's take a closer look at some types:

  • Otitis externa. Usually appears in the form of a boil. Even a minor injury can cause illness. You need to carefully clean your ears using regular cotton wool.
  • Otitis media It is a consequence of a runny nose. Staphylococci, streptococci, and pneumococci can lead to it. This type can be acute, recurrent, chronic. By nature it is divided into catarrhal or purulent.
  • Interior. It is called labyrinthitis. The inflammation is localized in one of the deepest levels of the hearing organ. Doctors to this day cannot say with certainty about the causes of the disease.

What does otitis media look like?

Antibiotics for children

There are many conflicting opinions about whether antibiotics are needed to treat otitis media. They can cope with bacteria and germs, but taking them is not always advisable. Most doctors agree that as long as the membrane is perforated and cleared of exudative fluid, there is no need to take antibiotics.

When are they required?

For otitis media, drugs with antibacterial action must be prescribed if:

  • the patient is less than 2 years old;
  • signs of intoxication of the body are noted;
  • body temperature remains above 39 degrees;
  • there is severe pain.

When can you do without them?

If the doctor chooses a “waiting tactic,” then it is better not to give the child antibiotics on his own. In the external form, anti-inflammatory ointments or drops with an analgesic effect can be used.

You can do without antibacterial drugs even with catarrhal form. It is expressed in inflammation of the middle ear without purulent contents. In this case, less aggressive drugs are prescribed that do not destroy the beneficial microflora of the ear.

How to insert drops into the ear for otitis externa

Features of treatment

To treat otitis media, local or systemic drugs are used. The first type includes drops. With inflammation of the outer ear, the infection does not penetrate the eardrum, but with a high probability it can be assumed that bacterial flora has joined the disease. Therefore, treatment must be comprehensive.

Systemic drugs include various:

Most popular drugs

It has been established that most bacteria that cause inflammation of the middle ear are resistant to penicillins. But drugs of this series continue to be quite popular because they are well tolerated by children and have a minimal number of various adverse reactions.

Amoxicillin is most often prescribed. On sale it is usually known as “Flemoxin Solutab”. It is made in powder form for solution or in the form of sweet tablets. More serious drugs in the same group include Amoxicillin Clavulanate or Amoxiclav.

Doctors, if necessary, treat otitis with antibiotics and prescribe cephalosporins. They help if the bacteria that led to the disease have shown resistance to medications from the first group. The disadvantages of such drugs include the destruction of vitamin K and disruption of hematopoietic functions.

Despite this, macrolides are used for children only in cases where other medications have not brought the desired result. These include Azithromycin, Roxitomycin, Clarithromycin.

Local medications in drops

All ear drops can be divided into several groups:

  • with a combined composition,
  • single drugs,
  • antibacterial drops.

Otofa is most often prescribed. This antibacterial drug is widely used for ear diseases. Not suitable for children intolerant to rifamycin. Sofradex is used to treat otitis media in infants and children of all ages.

Older children, after 12 years of age, are prescribed Neladex. Since intolerance to the active substance is often observed, it is prescribed with extreme caution.

The following topical drops may be prescribed:

  1. Miramidesis. Used after the first year of life.
  2. Anauran. A combined drug with antibacterial, antifungal, analgesic effects. Side effects are rare.
  3. Garazon. Prescribed for children over 8 years of age. The drops combine a broad-spectrum antibiotic and betamethasone.

Drugs for the treatment of otitis in children

Dosage

The course of treatment using systemic antibiotics is 5-7 days. In some cases, it takes longer to fight the infection. Then doctors prescribe the drug above.

The dosage of the drug is prescribed only by a pediatrician, since it depends on the age and weight of the baby. In case of an overdose, severe allergies, thrush or other more serious consequences may occur.

Should we be afraid?

You should not put antibiotics in your ears until your doctor says that your eardrum is intact. In general, parents should not be concerned about treating their children with antibiotics.

The spread of infection and the acquisition of a chronic form can lead to more serious consequences, for example, hearing loss, the development of bacterial flora and the involvement of other systems and organs in the inflammatory process.

Reviews from Dr. Komarovsky about the treatment of otitis media with antibiotics:

Dangerous symptoms of overdose or allergy

Some medications, when overdosed, have a negative effect on the auditory nerve. Therefore, hearing loss may result. This mainly applies to combination drugs intended for adults. Sometimes, due to the lack of the necessary medicine at hand, they are used.

In case of allergies or overdose, the baby may complain:

Parents may notice the appearance of hives and other skin reactions to the active substance. In rare cases, when taking systemic drugs, Quincke's edema appears.

Advantages and disadvantages

The advantages of antibacterial drugs include:

  1. Indispensable for bacterial infections. Otitis often occurs due to bacteria, so antibiotics can help you cope with the disease faster.
  2. Large selection of drugs. You can choose a remedy based on the child’s age and the presence of concomitant diseases.
  3. Possibility to reduce the risk of relapse.

Forecast

With the right drug, the prognosis after taking antibiotics is favorable. Otitis media in a child goes away for a long time or forever. To achieve quick results, it is recommended to use an integrated approach to treatment. If otitis media is advanced, then there is a high probability of developing permanent hearing loss.

Source: http://gidmed.com/otorinolarintologija/lekarstva-lor/antibiotiki-dlya-detej.html

Antibiotics for otitis media in children. Ear drops and antibiotics for the treatment of otitis media

Otitis is one of the most common inflammatory diseases in children under three years of age. It happens in both older children and adults, but less often. This is caused by the special structure of the ear canal, due to which any infection from the throat and nose gets into it. Even if an infant is not fed properly, middle ear inflammation can occur. All parents are concerned about curing their baby as soon as possible. They often purchase medications without consulting a doctor. But this cannot be done, because the question of whether antibiotics are needed for otitis media in children is still controversial. After all, the bacteria that cause inflammation of the middle ear are able to adapt to antibacterial drugs, so they can only be prescribed by a doctor after an accurate diagnosis.

How to determine that a child has otitis media?

During this disease, the child experiences pain, congestion in the ear, and hearing loss. The temperature often rises, the patient refuses to eat, cannot sleep normally, and is restless. The most difficult thing to diagnose is an infant who cannot say what hurts. Therefore, at the first symptoms and suspicion of inflammation of the middle ear, it is necessary to show the baby to an otolaryngologist. Only by examining the eardrum can an accurate diagnosis be made. The effectiveness of treatment without complications depends on how quickly this is done. Doctors often prescribe antibiotics for otitis in children, but the need for this depends on many factors. And in many cases, the disease goes away without the use of antibacterial drugs.

Pros and cons

Are antibiotics needed for otitis media in children? The advisability of taking such drugs has long been debated. After all, a large number of side effects and the ability of bacteria to adapt to many medications often negate all treatment. But in many cases it is impossible to do without antibiotics, especially when it comes to otitis media in a small child. To prevent complications, it is necessary to take antibacterial drugs. When can you do without this?

- if the child is over 2 years old, doctors recommend a wait-and-see approach, because in many cases the child’s body copes with inflammation on its own;

- if the disease is caused not by bacteria, but by a viral infection, then the use of antibiotics will be useless;

- if the child does not have symptoms of intoxication and high temperature;

- if only one ear hurts and the disease is mild.

Otitis in a child - treatment

Antibiotics are not the only medications that can alleviate a patient’s condition with otitis media. Usually, in the first 1-2 days of the disease, painkillers and antipyretics are used. Every mother should know how to cope with a disease such as otitis media. Treatment:

— antibiotics are prescribed for temperatures above 39 degrees and severe intoxication;

- anti-inflammatory drugs are prescribed to relieve pain and reduce temperature: Nurofen, Ibuprofen or Panadol;

- if pus does not come out of the ear, it is advisable to use ear drops: “Otipax” or “Otinum”, they have an anti-inflammatory and analgesic effect;

- if the child does not have a fever, the pain can be relieved with warm compresses with camphor oil or alcohol;

— to reduce the inflammatory process in the ear in children, it is necessary to use vasoconstrictor drops in the nose.

The best antibiotics for otitis media

Despite the fact that many bacteria that cause inflammation of the middle ear are resistant to penicillins, antibacterial drugs of this series are still the most popular. After all, they are the easiest to tolerate and have fewer side effects. The most commonly prescribed antibiotic for otitis media is Amoxicillin. Treatment with cephalosporins is also widespread: Cefazolin or Cefipime is used. Antibacterial drugs are used in the form of tablets, suspensions or syrup. If a child has an allergic reaction to these medications or no improvement is observed after two days of use, stronger antibiotics are prescribed: Clarithromycin, Levofloxacin, Vantin, Omnitsef and others. Sometimes, to enhance the effect, antibiotics for otitis in a child are used in the form of injections. After all, some children refuse to drink tablets and suspension, and syrups often cause an allergic reaction.

Antibiotics of the penicillin group

Most often, it is with these drugs that treatment of otitis media begins. They are best tolerated by children and have few side effects. The most common antibiotic for otitis media is Amoxicillin. It is better known to parents as “Flemoxin Solutab”. It is made in powder form for suspension or in sweet tablet form to make it easier for your child to take. If the drug does not bring improvement in a few days, it can be replaced with a stronger medicine of the same group - Amoxicillin Clavulanate or Amoxiclav. It is more effective, but also well tolerated by children. Other common antibiotics for otitis in a child are Ampicillin and Sultamicillin. They also belong to this group and are contraindicated if you are intolerant to penicillin.

Drugs of the cephalosporin group

These are also commonly prescribed antibiotics for otitis media in children. Modern drugs in this group are effective against bacteria resistant to penicillins, but are also well tolerated. The most common drug prescribed to children is Cefuroxime Axetil. The drug "Cefpodoxime Procetil" or "Omnitsef" is also used. These antimicrobial agents are effective against otitis media. But although they rarely cause allergic reactions, they are not always prescribed to children. The most dangerous side effect of cephalosporins is the destruction of vitamin K and disruption of hematopoietic functions.

Macrolide group

This is a new generation of antimicrobial drugs that have some advantages over other antibiotics. Having a wide spectrum of action and high activity against most bacteria, they have almost no side effects. But despite this, these medications are used with caution in children, only in extreme cases when other medications do not help. The most commonly prescribed antibiotics for otitis in a child are the drugs Clarithromycin, Roxithromycin and Azithromycin. In addition to their antimicrobial effect, they stimulate the immune system and relieve inflammation. But their strong effect on the immune system is the reason that macrolides are rarely prescribed to children.

Ear drops

One of the mildest forms of inflammation is otitis externa. Antibiotics in tablets in this case are prescribed extremely rarely; it is usually possible to get by with local drugs. But in case of severe inflammation, you can use drops containing antimicrobial substances. They are also used for otitis media. Which of them are the most common:

— The most commonly prescribed drug is Candibiotic. It contains two strong antimicrobial drugs and lidocaine, which provides its rapid analgesic and anti-inflammatory effect.

— The drug “Anauran” is a very strong antibiotic that also contains lidocaine. But it cannot be used for allergies and perforation of the eardrum.

— The drug “Otofa” contains a very strong antibiotic and is effective for any inflammation in the ear. But these drops do not have an analgesic effect.

— The drug “Normax” is used more often because it has a wide spectrum of action. Sometimes it can cause an allergic reaction.

— The medicine “Sofradex” is a hormonal drug and is rarely prescribed to children.

Features of the use of antibiotics

- Such medications should only be prescribed by a doctor. If antibacterial drugs are used incorrectly, in addition to allergic reactions, complications may occur and otitis may become chronic.

- Do not exceed the dosage of the medicine prescribed by the doctor. In addition to the fact that this can cause an allergic reaction and dysbiosis, the body may develop immunity to such drugs.

- Usually antibiotics are taken for 5-7 days. It is unacceptable to increase this period without a doctor’s recommendation. You should also not interrupt treatment if it seems that the disease has passed.

- If after 2-3 days of taking the drug there is no improvement, you need to replace it with a stronger medicine.

— Usually, along with an antibiotic, the doctor prescribes antihistamines to prevent allergies and probiotics and bifidobacteria to protect the gastrointestinal tract.

Side effects after using antibiotics

Every mother needs to know that one of the most common diseases in babies is otitis media. Antibiotics help to quickly cope with inflammation and prevent complications. But these drugs greatly harm the rest of the child’s organs and systems. Most often, after using antibiotics, allergic reactions occur: itching, rash, redness of the skin, swelling and even anaphylactic shock. In addition, these drugs have a strong effect on the gastrointestinal tract: they cause abdominal pain, diarrhea, nausea, flatulence and dysbacteriosis. Some antibiotics can cause kidney and liver dysfunction. When the first signs of side effects appear, you should stop taking the drug and consult your doctor.

Source: http://www.syl.ru/article/166540/new_antibiotiki-pri-otite-u-detey-ushnyie-kapli-i-antibiotiki-pri-lechenii-otita