The baby is crying and scratching his ears. He may have otitis media.
Acute otitis media in infants is a common infectious disease. The incidence rate is second only to cold clinically, and it is also the most common complication after cold. Statistics from the United States show that acute otitis media is the disease that American pediatricians prescribe the most antibiotics. Many mothers may have such doubts, the middle ear is hidden in the ear, how did the germs get in? The answer is simple: The nasopharynx and the ear are connected through the eustachian tube, The eustachian tube of infants is especially short, It is also relatively wide and flat. The nozzle is usually open, And just communicates with the middle ear, If a bacterial or viral infection occurs in the nasopharynx, It is easy to infect the middle ear through the eustachian tube, causing inflammatory reaction. The bacteria that cause acute otitis media are often Streptococcus pneumoniae, Haemophilus influenzae, etc., and the viruses that cause acute otitis media are often influenza viruses, respiratory syncytial viruses, etc. Although viruses can also cause otitis media, in general, acute otitis media is still dominated by bacterial infection.
Children with acute otitis media often show ear pain, Cry more than, and often use the hand to grasp the ear, accompanied by fever, refused to eat milk and other symptoms. If accompanied by tympanic membrane perforation, may also see purulent mucus secretions flowing out of the ear, children’s hearing loss. Suffered from acute otitis media, should be actively and thoroughly treated, as long as timely treatment can generally heal and do not leave sequelae.
For the diagnosis and treatment of acute otitis media in infants, In early 2013, the American Academy of Pediatrics updated < Guidelines for Diagnosis and Treatment of Acute Otitis Media in Children > >, To provide recommendations for diagnosis and treatment of uncomplicated acute otitis media in children aged 6 months to 12 years. These recommendations are based on evidence-based medicine and provide stricter diagnostic criteria for acute otitis media, aiming at reducing unnecessary antibiotic use. The main diagnostic recommendations include:
First, acute otitis media should only be diagnosed when there is moderate to severe tympanic membrane expansion or new otorrhea caused by non-acute otitis externa.
Second, mild tympanic membrane expansion and ear pain for less than 48 hours, or severe tympanic membrane expansion, may be otitis media. For children who cannot speak, scratching, pulling, rubbing or rubbing the ear may indicate ear pain.
Choice of Medication for Otitis Media
The treatment of otitis media should be based on the baby’s age, illness and other specific conditions. The main treatment recommendations include:
First, children with bilateral or unilateral acute otitis media accompanied by severe symptoms or signs (such as moderate or severe earache, or earache lasting more than 48 hours, or body temperature 39 ℃ and above) should use antibiotics.
Second, doctors should prescribe antibiotics for children suffering from bilateral mild to moderate otitis media for 6 to 11 months. For 6 to 11 months of children suffering from unilateral moderate to severe acute otitis media, doctors can prescribe antibiotics for treatment, or on the basis of parents’ consent, temporarily do not use antibiotics, but need close follow-up. Once the symptoms of the child worsen or the symptoms do not improve within 48 to 72 hours, antibiotics should be started.
Third, amoxicillin should be the first choice antibiotic for the treatment of bacterial acute otitis media. The recommended dose is 80-90 mg per kilogram of body weight per day, Take it in two doses. This recommended dose is much larger than that given in the Chinese drug instructions. Therefore, the drug cannot be administered simply according to the instructions, It is more scientific to administer drugs according to body weight. Amoxicillin-clavulanate potassium can also be preferred. This is a compound preparation, in which amoxicillin is the main effective component, and potassium clavulanate is the-lactaminase inhibitor, which is used to combine with-lactaminase produced by pathogenic bacteria to inactivate it, so as to prevent it from damaging the effect of amoxicillin, thus improving the curative effect of amoxicillin.
Fourth, for recurrent acute otitis media, tympanic membrane catheterization is recommended instead of preventive use of antibiotics.
Fifth, the treatment of acute otitis media should include the assessment of pain symptoms. If there is pain, anti-inflammatory analgesics (such as ibuprofen) should be used to reduce the pain.
Omni-directional prevention of otitis media
Measures to prevent acute otitis media in infants include:
- Preventing colds. As described above, inflammation of pharynx and nose spreads to eustachian tube after catching a cold. Hyperemia and swelling of pharyngeal mouth and lumen mucosa of eustachian tube will lead to pathogenic bacteria invading middle ear and causing otitis media. Therefore, preventing colds can reduce the chance of otitis media. Use the correct method of blowing nose.
Incorrect methods of blowing your nose can also lead to otitis media.
Some people often use two fingers to hold the nasal alar on both sides when blowing their noses, and force the nasal mucus to blow out. This method of blowing the nose not only cannot completely blow the nasal mucus but also may cause diseases. If the nostrils on both sides are pinched and forced to blow hard, the pressure forces the nasal mucus to flow out to the back of the nose, reaching the eustachian tube and then flowing back to the middle ear, thus inducing otitis media.
Therefore, the correct method of blowing your nose should be advocated:
Press and hold one nostril with your fingers, blow the nasal mucus out of the opposite nostril slightly, and blow the other side again with the same method. If the nasal cavity is blocked and the nasal mucus is not easy to blow out, you can spray the nasal cavity with physiological saline or physiological seawater nasal cavity spray, and then blow it after the nasal cavity is ventilated.
- Avoid swallowing water in your mouth when swimming, In order to prevent water from entering the middle ear through nasopharynx and causing otitis media. If infants eat milk in supine position, Otitis media is caused by choking the eustachian tube into the middle ear in the Book of Changes. Therefore, mothers should take their seats when feeding their babies. Pick up the baby and suck milk obliquely. Vaccinate the baby with pneumococcal conjugate vaccine and annual influenza vaccine according to the vaccination schedule. It has certain effect on preventing otitis media. Mothers should actively carry out exclusive breast-feeding until the baby is at least 6 months old. Immune factors in breast milk and the posture adopted during breast-feeding may help reduce the occurrence of otitis media.
This article is taken from the book “Ji Lianmei Talk: Chinese Should Use Drugs This Way”, which is reprinted by the author’s authorized clove garden.