Recurrent Ear Infections and Persistent Effusion

Topic Overview

Some doctors may recommend the use of daily antibiotics for prevention (prophylaxis) of ear infection if your child has many recurrent ear infections. Talk to your doctor about this. Antibiotics can reduce by 1 the number of infections that would have occurred without antibiotics. If your child has at least 3 ear infections in a 6-month period or has 4 ear infections in 1 year, your doctor may prescribe a low dose of antibiotics for your child to take daily during the season when he or she is prone to ear infections. The risks of taking daily medicines include:

  • Possible side effects from the medicine, such as nausea or diarrhea.
  • The cost of the medicine.
  • The risk of developing bacteria that are resistant to the prophylactic medicine.

In certain cases, long-term use of antibiotics may be just as effective as ear tubes in preventing infection. The value of long-term antibiotic use should be weighed against the risk that your child may develop bacteria that are resistant to the medicine.

If your child has persistent infection in spite of multiple antibiotics, your doctor may wish to remove fluid from the middle ear space (myringotomy). This fluid will be sent to a lab for culture to identify which bacteria are causing the infection and help identify the best antibiotic to use to fight the infection. Ear tubes may be placed at this time to help drain the fluid.

In some children, fluid behind the eardrum (effusion) lasts for longer than 3 months after an ear infection. If hearing loss is present, antibiotics or ear tubes may be appropriate treatment choices. If your child still has fluid and hearing loss after 4 to 6 months, your doctor may recommend ear tubes. Ask your doctor about the long-term risks and benefits of continued observation, antibiotic use, and ear tubes.


Author Jan Nissl, RN, BS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Tracy Landauer
Primary Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Specialist Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Last Updated February 12, 2010

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