Posted by: Marlise | 2010/02/21

Ear infection

Hallo doctor,
My son is 18 months old, he received his grommets about 4 - 5 months ago. The problem that I have is that he keeps on having infection in the left ear and then it goes to to his nose, throat, tonsiils etc, and he literally becomes sick, receiving antibiotics etc. He is attending a daycare and I know it is normal for a child at a daycare to become sick oftenly. His peaditrican did prescribe him Zyrtec as well and he is using 5 drops of Zyrtec in the morning and night. 3 Weeks ago he had broncal pneumonia and was put on a antibiotic drip and also received Augmentin and Zitromax. He has started with his left ear again from last week and I am using Excocin every time he gets the ear infection, but it only helps to a certain extend. There is a yellowish phlegm discharge and there is also a smell present. My question is why is my son having ear infection oftenly, only in the left ear and after a few days that he used the antibiotics the discharge is back. Can you please advise me what the problem might be. Could it be that the good bacteria in the ear is imbalanced because of all the antibiotics or maybe a problem with the left ear''s grommet?
Thank you doctor.

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Our expert says:
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Dear Marlise,

The grommet itself does not cause infection, as it only creates an artificial opening in the middle ear cleft. The function of the grommet is to allow air onto the middle ear, in order to ventilate the ear. Unfortunately this does not always protect against further infection, as any bacteria /virus may still find its way into the ear, usually via the nasal cavity. It is unlikely that the infection in the ear is causing the rest, as the pattern of spread is usually the other way around, ie. from the throat to the ear.
He requires an ENT examination to establish the role of the tonsils as a possible cause, as well as a propper cleaning of the ear in order for the drops to work effectively.
The reasons why the ear is not getting better could be as follows:
1. Incorrect antibiotics, due to resistance.
2. Inproper cleaning of the ear before the drops are inserted.
3. Treatment of the discharging ear with systemic antibiotics only.

The ear does not have good bacteria, unlike the rest of the digestive tract, it should in fact have no bacteria at all.
I suggest your ENT does a swab of the ear to see which organism is causing the problem, and to change the drops if this is needed. It is also important to keep the ear dry to assist with healing. The reason why the drops are not effective in this case may be due to resistance.
Unfortunately regular infections is very common in children attending daycare, and can not be avoided.


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