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Ask Internist Your Own Question

Internist
Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 1066
Experience:  MBBS,MD (USA)Diplomate American Board of Internal Medicine
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hi. my son has had an ear infection that just wont go away.

Customer Question

hi. my son has had an ear infection that just wont go away. it will be 2 weeks on wednesday. on thursday he started co amoxiclav for 7 days. his temperature was ranging up to 39. the antibiotic seemed very slow to react, however by day 5 he seemed to be eating and temperature was gone. we stopped at day 7. 1/2 days later again he complained of ear pain and his temperature was back but this time up to around 38. i took him to see ent and he said the infection was on way out but if it doesnt clear up in a few days put him on cefaclor 125mg 2 times daily. it will be 3 days tonight. again he does seem to have responded and had his longest period without pain killers and from yday morning to this afternoon. however now again his temp went to 38.5. i took him to gp and he suggested to also give him azithromycin 200mg once daily and continue with the cefaclor. my son had pneumonia 2 years ago (he is 4 years old). he has had some history of ear/throat infections and has prob been on antibiotics 12 times. most the time co amoxiclav clears it up. is is safe to give these antibiotics together? i have seen on internet some research indicating combining some antibiotics can make things worse. are these 2 safe to take together?
Submitted: 2 years ago.
Category: Medical
Expert:  Internist replied 2 years ago.
Dear JA Customer
Sorry to hear about your son's recurrent problem
Before we discuss further,
Did you son ever had test called laryngoscopy/Complete exam of throat,nose and Ear by ENT doctor?
How many times he had infection in last one year?
Any swelling in throat?
Thanks
Customer: replied 2 years ago.

no he has not had this test. this year he had one prior infection in jan. so we had a good run. the year before he probably had 4 infections. and the year prior to that in 2012 he had his pneumonia in dec.

Expert:  Internist replied 2 years ago.
Thanks for the promopt reply.

As far as treatment of this ear infection is concerned , amoxicillin is the treatment of choice and unless patient has received the same medication in last 30 days, there is usually no need to add any other medication and the reason your GP added the medication is probably the same...

However i am more concerned about the recurrence of this infection, acute symptoms will get better with antibiotics but given the fact that he is having recurrent infections there is need for further testing and to look for any predisposing factors.

He should be seen by ENT and should undergo detailed Ear and throat exam to make sure there is no obstruction in connection of throat and ear through the tube..
Based on clinical exam he may need imaging tests like CT Scan...

Recurrent ear infections can cause serious complications which include but not limited to spread of infection to adjacent bones, hearing loss etc.. so i would stress the need for urgent exam by ENT and close follow ups to see resolution of the symptoms and imaging if needed

Again as far as antibiotic combincation is concerned,there is no harm and azithromycin would help covering more bacterial infections...

I hope the info helps, please feel free to ask if you have any follow up questions
Expert:  Internist replied 2 years ago.
Is there any thing else i can help you with?
Please feel free to ask if you have any more questions or concerns,
If you are satisfied with the answer, please click ACCEPT so that i get credit for my answer.

Thanks

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