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DrOAB
DrOAB, Board Certified Pediatrician
Category: Paediatrics
Satisfied Customers: 1032
Experience:  In practice since 2000.
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Hi, my son is now 11 months, he had his first ear infection

Customer Question

Hi, my son is now 11 months, he had his first ear infection end of May - amoxicillyn prescribed, month later another ear infection amoxicillyn presecribed again, 3 weeks later amoxicillyn prescribed again and his ear then got worse with brown pus oozing over three week period. Went to dr again who sent him to child assessment unit at hospital who admitted him and gave him antibiotics intravenously over 24 hours and then he was sent home with 9 days of co-amoxiclav 3 times a day. Ent consultant said the mistake was keep giving him same antibiotic knowing wasnt clearing up. His adenoids were very enlarged too. Two weeks later ear full of pus again, dr saw him who saw him in May first time read notes and took a swab and prescribed amoxicillyn even tho I told her doesnt work. Am now waiting on result if swab which drs said would be today and hasnt arrived and then said they are closed for staff training this afternoon. My son is in pain in waves and im not giving him the amoxicillyn this time as pointless. Shall I firstly complain about GP surgery as they dont seem to be paying enough attention to this problem. The ear drum is perforated and My daughter had to have grommets at 18 mths to 2 years. Shall i go through Bupa for ENT appt with a view to grommets ? Thanks
Submitted: 2 years ago.
Category: Paediatrics
Expert:  DrOAB replied 2 years ago.
Customer:

Hello. I do not think he is a candidate for ear grommets just yet. He was mismanaged multiple times with the same antibiotic, to which his ear bacteria are obviously resistant. If he showed failure to clear the same ear infection after 2-3 different antibiotics or if he shows more than 4 separate ear infections over 6 months or more than 6 separate ear infections over 12 months, then he would meet clinical criteria for consideration of ear grommet surgery.

Customer:

If he has serious hearing problems because of this, that is another criterion for consideration of ear grommet surgery.

JACUSTOMER-wdqtdb20- : Thanks. This will be the fourth ear infection since end of May and the gp just prescribes amoxicillin even tho they know it doesn't clear it up ??? Can you suggest what I should do as next course of action please ? Am waiting on ear swab results - thanks
Customer:

The ear swab culture test will hopefully confirm the exact bacteria causing the infection as well as what antibiotics would work against it. This will allow the physician to prescribe an effective antibiotic choice. Also, I actually suspect that this is not four separate ear infections, but possibly the first one inadequately treated over all this time. Did you say his ear drum is currently perforated?

Customer:

Correction: Perhaps 2 separate ear infections if the in-hospital intravenous antibiotics actually did clear the first infection.

JACUSTOMER-wdqtdb20- : Yes perforated and I suspect first one not cleared up - do u think will effect his hearing ?
Customer:

Since his ear drum is perforated, it will not be possible to place a grommet until it has fully healed, which may take up to 8 weeks in most cases. If the ear structures are still intact, then hopefully this will not affect his hearing. There are OAE devices that can actually screen for hearing problems in children this young -- the ENT specialist or an audiologist may consider the use of such a hearing screening device.

JACUSTOMER-wdqtdb20- : Ok thanks very much
Customer:

You are quite welcome. Be sure call your GP 48-72 hours after the ear culture swab was sent for testing to confirm a good antibiotic choice.

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