Antibiotics??

BlessUrHeart29 · May 2014

DS has an ear infection (the dr described it as "impressive" in that there is a lot of fluid built up). The doctor at the walk in clinic gave us an Rx for antibiotics for him, but said that we could give him a day or two to see if it clears on it's own, because he couldn't tell us if it was viral or bacterial.

First of all, any thoughts on how to know if antibiotics are the right choice for right now?

Second, are there any questions I should ask in the future when we are with the doctor to help me figure it out better?

hartsl01 · May 2014

I would give him the antibiotics. We haven't had any ear infections (knock on wood) but we've had several colds and pneumonia. He's been on antibiotics 3 times and after the first dose, I notice a huge difference, he's a much happier baby because he's already feeling better.

Obviously you know your LO best, so follow your gut. Call your pedi and get their opinion or talk to the pharmacist where you pick up the medicine.

Amjoy25 · May 2014

Actually, I probably would not have given him any antibiotics, as usually ear infections are just viral...however, if it was "impressive" and he has a fever, I would give him the antibiotics and something for pain, like Motrin. There is an observation clause with ear infections and children, but anything described as "impressive" with fever and pain, is a good reason to give antibiotics IMO.

BlessUrHeart29 · May 2014

Okay well something weird is going on, so we're going back to the doctor this afternoon. We gave him Motrin an hour ago and he's still registering a 101.3 fever under his armpit.

shelley1002 · May 2014

Antibiotics are the only way DS1's ear infections cleared up. I had never heard of not giving antibiotics for ear infections until a few weeks ago.

catycate · May 2014

It depends on how much pain he is in. DS had tons and tons of ear infections and my pedi said that 95% are viral and there isn't an easy way to tell. My mother is an NP and she agreed. My pedi would usually write me a prescription and tell me to wait and see for a couple of days. The concern is immunity to antibiotics from over prescribing. The antibiotics won't work when you truly need them. But, pain + fever, I would give it.

Amjoy25 · May 2014

Omg ^^^^^ I'm dying. As a health care provider, it would be wise to use the antibiotics especially since he has a fever that you cannot control with Motrin. I would never take advice like "give BM" for a fucking bacterial ear infection. ::bangs head on desk::

BlessUrHeart29 · May 2014

Okay so we took him back to see another doctor and he said generally they advise to wait and see before starting antibiotics, but considering that he wasn't doing well, he recommended going ahead with the meds, which is what we'll do.

Thanks for your advice, everyone!

jennlin · May 2014

breastmilk kills bacteria. it's not as far out as you think. @amjoy25

https://kellymom.com/bf/can-i-breastfeed/illness-surgery/healing-breastmilk/

https://www.askdrsears.com/topics/feeding-eating/breastfeeding/why-breast-is-best/how-human-milk-protects-babies-illness

Amjoy25 · May 2014

crunchymama11 said:

Amjoy25 said:

Omg ^^^^^ I'm dying. As a health care provider, it would be wise to use the antibiotics especially since he has a fever that you cannot control with Motrin. I would never take advice like "give BM" for a fucking bacterial ear infection. ::bangs head on desk::

most ear infections aren't bacterial and antibiotics won't help anyway if it's viral. It's also well-known in the medical community that antibiotics are way over prescribed in general and for ear infections in particular. As a NP you should know that.

I do know that...see my first post to OP. However, a tympanic membrane that I would consider "impressive" means it looks pretty gnarly, and that fact that this poor child has a high fever and is miserable, makes me think it's most likely bacterial. So while I advocate for observation on most OM's I see, I also know that with fever, ear pain, and general malaise, antibiotics are probably appropriate. No where in my books did I read, eh, just give the kid BM in his damn ear. I'm not saying there can't be use for it, but in this case, just no.

cassey910 · May 2014

No advice but hope he feels better soon.

psychdoc12 · May 2014

Amjoy25 said:

Omg ^^^^^ I'm dying. As a health care provider, it would be wise to use the antibiotics especially since he has a fever that you cannot control with Motrin. I would never take advice like "give BM" for a fucking bacterial ear infection. ::bangs head on desk::

Preach.

Amjoy25 · May 2014

jennlin said:

breastmilk kills bacteria. it's not as far out as you think. @amjoy25

https://kellymom.com/bf/can-i-breastfeed/illness-surgery/healing-breastmilk/

https://www.askdrsears.com/topics/feeding-eating/breastfeeding/why-breast-is-best/how-human-milk-protects-babies-illness

If I used either of these sources in school...I would be kicked out.

psychdoc12 · May 2014

Amjoy25 said:

jennlin said:

breastmilk kills bacteria. it's not as far out as you think. @amjoy25

https://kellymom.com/bf/can-i-breastfeed/illness-surgery/healing-breastmilk/

https://www.askdrsears.com/topics/feeding-eating/breastfeeding/why-breast-is-best/how-human-milk-protects-babies-illness

If I used either of these sources in school...I would be kicked out.

Not to mention the fact that the kid is febrile, the membrane is probably bulging, what is applying BM to the outside of the membrane going to do? Is it going to penetrate into the canal and clear everything up? That would be a miracle.

psychdoc12 · May 2014

crunchymama11 said:

Amjoy25 said:

crunchymama11 said:

Amjoy25 said:

Omg ^^^^^ I'm dying. As a health care provider, it would be wise to use the antibiotics especially since he has a fever that you cannot control with Motrin. I would never take advice like "give BM" for a fucking bacterial ear infection. ::bangs head on desk::

most ear infections aren't bacterial and antibiotics won't help anyway if it's viral. It's also well-known in the medical community that antibiotics are way over prescribed in general and for ear infections in particular. As a NP you should know that.

I do know that...see my first post to OP. However, a tympanic membrane that I would consider "impressive" means it looks pretty gnarly, and that fact that this poor child has a high fever and is miserable, makes me think it's most likely bacterial. So while I advocate for observation on most OM's I see, I also know that with fever, ear pain, and general malaise, antibiotics are probably appropriate. No where in my books did I read, eh, just give the kid BM in his damn ear. I'm not saying there can't be use for it, but in this case, just no.

Sine you cannot ascertain if it is bacterial or not, neither can I. That's why I said I would have to be in the situation. I was giving an alternative to try before giving the antibiotics, esp if she chooses to wait a day or 2 she can try something else. And maybe antibiotics are the right answer- IDK. neither one of us can say 100% online. If she wants to give the antibiotics she can. I was just offering an alternative.

I'm a psychiatrist, so I guess you can take this with a grain of salt, but I did do a peds rotation and my concern with this advice is that untreated bacterial otitis media can have complications such as a ruptured tympanic membrane, which can lead to scarring, etc.

jennlin · May 2014

psychdoc12 said:

crunchymama11 said:

Amjoy25 said:

crunchymama11 said:

Amjoy25 said:

Omg ^^^^^ I'm dying. As a health care provider, it would be wise to use the antibiotics especially since he has a fever that you cannot control with Motrin. I would never take advice like "give BM" for a fucking bacterial ear infection. ::bangs head on desk::

most ear infections aren't bacterial and antibiotics won't help anyway if it's viral. It's also well-known in the medical community that antibiotics are way over prescribed in general and for ear infections in particular. As a NP you should know that.

I do know that...see my first post to OP. However, a tympanic membrane that I would consider "impressive" means it looks pretty gnarly, and that fact that this poor child has a high fever and is miserable, makes me think it's most likely bacterial. So while I advocate for observation on most OM's I see, I also know that with fever, ear pain, and general malaise, antibiotics are probably appropriate. No where in my books did I read, eh, just give the kid BM in his damn ear. I'm not saying there can't be use for it, but in this case, just no.

Sine you cannot ascertain if it is bacterial or not, neither can I. That's why I said I would have to be in the situation. I was giving an alternative to try before giving the antibiotics, esp if she chooses to wait a day or 2 she can try something else. And maybe antibiotics are the right answer- IDK. neither one of us can say 100% online. If she wants to give the antibiotics she can. I was just offering an alternative.

I'm a psychiatrist, so I guess you can take this with a grain of salt, but I did do a peds rotation and my concern with this advice is that untreated bacterial otitis media can have complications such as a ruptured tympanic membrane, which can lead to scarring, etc.

--

Her pedi suggested waiting a day or two--why not put BM on it in the meantime? Instead of sitting idly waiting for it to pass.

psychdoc12 · May 2014

I'm a psychiatrist, so I guess you can take this with a grain of salt, but I did do a peds rotation and my concern with this advice is that untreated bacterial otitis media can have complications such as a ruptured tympanic membrane, which can lead to scarring, etc.

In her OP she said the pedi said she could wait a day or 2 to see if it clears. I was going off her OP.

Fair enough.

Amjoy25 · May 2014

psychdoc12 said:

crunchymama11 said:

Amjoy25 said:

crunchymama11 said:

Amjoy25 said:

Omg ^^^^^ I'm dying. As a health care provider, it would be wise to use the antibiotics especially since he has a fever that you cannot control with Motrin. I would never take advice like "give BM" for a fucking bacterial ear infection. ::bangs head on desk::

most ear infections aren't bacterial and antibiotics won't help anyway if it's viral. It's also well-known in the medical community that antibiotics are way over prescribed in general and for ear infections in particular. As a NP you should know that.

I do know that...see my first post to OP. However, a tympanic membrane that I would consider "impressive" means it looks pretty gnarly, and that fact that this poor child has a high fever and is miserable, makes me think it's most likely bacterial. So while I advocate for observation on most OM's I see, I also know that with fever, ear pain, and general malaise, antibiotics are probably appropriate. No where in my books did I read, eh, just give the kid BM in his damn ear. I'm not saying there can't be use for it, but in this case, just no.

Sine you cannot ascertain if it is bacterial or not, neither can I. That's why I said I would have to be in the situation. I was giving an alternative to try before giving the antibiotics, esp if she chooses to wait a day or 2 she can try something else. And maybe antibiotics are the right answer- IDK. neither one of us can say 100% online. If she wants to give the antibiotics she can. I was just offering an alternative.

I'm a psychiatrist, so I guess you can take this with a grain of salt, but I did do a peds rotation and my concern with this advice is that untreated bacterial otitis media can have complications such as a ruptured tympanic membrane, which can lead to scarring, etc.

And, you know, hearing loss.

Amjoy25 · May 2014

Here's OP: after getting back from her appt., that she said she made because he's worse, whilst waiting 2 days....

BlessUrHeart29 · May 2014

OMG you guys I don't like it when we fight!! #sads

Things were a bit less dramatic by the time we got to the doctors office. Still a slight fever and definitely uncomfortable but he was better than earlier #motrinfortheassist.

I get why he initially said I could wait if I wanted to. So I did and it didn't seem to be working out too well, so we're going to try the meds. Hopefully ear infections won't be a recurrent ailment, because this has not been fun.

nbcarlson · May 2014

jennlin said:

psychdoc12 said:

crunchymama11 said:

Amjoy25 said:

crunchymama11 said:

Amjoy25 said:

Omg ^^^^^ I'm dying. As a health care provider, it would be wise to use the antibiotics especially since he has a fever that you cannot control with Motrin. I would never take advice like "give BM" for a fucking bacterial ear infection. ::bangs head on desk::

most ear infections aren't bacterial and antibiotics won't help anyway if it's viral. It's also well-known in the medical community that antibiotics are way over prescribed in general and for ear infections in particular. As a NP you should know that.

I do know that...see my first post to OP. However, a tympanic membrane that I would consider "impressive" means it looks pretty gnarly, and that fact that this poor child has a high fever and is miserable, makes me think it's most likely bacterial. So while I advocate for observation on most OM's I see, I also know that with fever, ear pain, and general malaise, antibiotics are probably appropriate. No where in my books did I read, eh, just give the kid BM in his damn ear. I'm not saying there can't be use for it, but in this case, just no.

Sine you cannot ascertain if it is bacterial or not, neither can I. That's why I said I would have to be in the situation. I was giving an alternative to try before giving the antibiotics, esp if she chooses to wait a day or 2 she can try something else. And maybe antibiotics are the right answer- IDK. neither one of us can say 100% online. If she wants to give the antibiotics she can. I was just offering an alternative.

I'm a psychiatrist, so I guess you can take this with a grain of salt, but I did do a peds rotation and my concern with this advice is that untreated bacterial otitis media can have complications such as a ruptured tympanic membrane, which can lead to scarring, etc.

--

Her pedi suggested waiting a day or two--why not put BM on it in the meantime? Instead of sitting idly waiting for it to pass.

My son had pink eye, that looked gross but didn't seem to be bothering him. I am hesitant about giving antibiotics so I called my pedi and they said wait a day or two. I squirted some BM in it and it was cleared up within 24 hours. I'm glad we avoided the antibiotics.

Phalaenopsis · May 2014

I'm just proud that people know not all infections require antibiotics. Consider yourselves informed. Amjoy knows this, obvi, and wouldn't recommend them lightly over the internets.

psychdoc12 · May 2014

I guess I don't see antibiotics as a particularly bad thing. If there are several signs consistent with a bacterial otitis, I'm going to want to start antibiotics as soon as possible to get my LO feeling better. I don't like having an untreated infection, I'm sure she doesn't either.

Amjoy25 · May 2014

psychdoc12 said:
I guess I don't see antibiotics as a particularly bad thing. If there are several signs consistent with a bacterial otitis, I'm going to want to start antibiotics as soon as possible to get my LO feeling better. I don't like having an untreated infection, I'm sure she doesn't either.

They're not, but too many kids were being treated with viral infections with atb's and causing resistance of the meds to the common bacteria. But I'm sure you know this.

OP I hope he feels better soon!

psychdoc12 · May 2014

Amjoy25 said:

I guess I don't see antibiotics as a particularly bad thing. If there are several signs consistent with a bacterial otitis, I'm going to want to start antibiotics as soon as possible to get my LO feeling better. I don't like having an untreated infection, I'm sure she doesn't either.
They're not, but too many kids were being treated with viral infections with atb's and causing resistance of the meds to the common bacteria. But I'm sure you know this. OP I hope he feels better soon!

Overused, yes, and we do need to be careful about that. But some seem to think they should be avoided at all costs and I don't agree with that. They're a great treatment when indicated.

huntjul · May 2014

quartermisses said:

What the hell, you guise? Who dubbed Thursday blind-leading-the-blind day? Hope he's doing better, op.

Blind leading the blind, what? I'm a veterinarian, cannot see said child or ear over the internet, yet surely I know if this child needs antibiotics.

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