Amherst ENT: Antibiotics are treatment of choice for childhood ear infections

Dr. Paul Young, an ear, nose and throat, head and neck surgeon, and his nurse, Shannon Nowicki look at a patient’s file in advance of an office procedure. (Sharon Cantillon/Buffalo News)

By Scott Scanlon

 

It took three years of writing WNY Refresh stories for me to interview an Ear, Nose and Throat doctor.

I have to believe all the aching, poking and prodding I’ve endured in my right ear since childhood had something to do with the time frame.

I got my first ear infection as a baby and suffered through them for years. My earliest hospital memory is being wheeled through Women & Children’s Hospital as a second-grader to get my adenoids and tonsils out – and my first set of ear tubes put in.

I was a young child of the 1960s, the decade when the number of ear infections started to climb among children.

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They continue to be one of the most common childhood ailments treated by primary care doctors and ENTs, Dr. Paul Young told me earlier this month during an interview in his Amherst office. You can read my profile story on him at buffalonews.com/life-arts/refresh.

The use of antibiotics has rightfully come in to question when they involve treatment of a variety of illnesses, but there is little debate they’re the treatment of preference for ear infections in the U.S.

Below are excerpts from our talk when it comes to those infections

Q. What’s the best way to treat a child’s ear infection?

Whether or not those ear infections make it to an ENT doctor depends on how complicated they are. Normally, they should be treated by pediatricians. Pediatricians send them to an ENT doctor if they’re not responding to one or two courses of antibiotics. We have to decide whether it needs to continue to be treated with medicine or needs to be treated with ear tubes. Sometimes it’s the adenoids and sometimes sinusitis. Sometimes, it’s a little bit more complicated and you have to be a little bit more comprehensive. The ear, nose and throat truly are connected. Sometimes it’s a nose problem that can manifest itself in your ear, so we have to tease those things out and treat appropriately.

Q. What’s the best way for a parent to handle a child’s ear infection, especially if their child is just starting to have them?

All parents have different levels of anxiety. Some people feel like they’re cheated if they come in and don’t walk out with an antibiotic. They’ve basically come in looking for medicine. Sometimes, I end up spending more time telling them why they don’t need one. There’s very different philosophies. In Europe, they don’t treat ear infections with antibiotics; it’s an American thing. We have to be cautious, because there are complications that can happen with ear infections and you don’t want to be caught not treating something that ends up in a complication. Meningitis is a complication of an ear infection. The reaction here is very different than Europe. The liability is different, the nature of the society is different.

Q. Is an antibiotic an effective treatment?

Generally. Most ear infections are caused by three cardinal bacteria. It might have started out as an upper respiratory virus, and the ear component is one spot for an opportunistic bacteria. Antibiotics are the first-line therapy. If it continues and continues and continues, the next step is maybe to put in ear tubes. Sometimes, you have to address the adenoid tissue. You have to look at allergies and sometimes you have to look at a patient’s immune system.

Q. When should a parent take a child to their first hearing test?

The first hearing test is done when a child is a newborn. That establishes whether or not there’s a congenital hearing problem. If a baby passes the newborn hearing screen, they don’t necessarily need to be screened for hearing again unless there’s an issue. If they don’t pass the newborn hearing screen, it’s imperative that they have good follow-up. If that child does indeed have some form of deafness, early intervention is imperative. If you don’t intervene before a child tries to acquire language skills, the results are fundamentally different.

Q. What are some of the signs someone might be losing their hearing.

The first sign is (often) when people say they can’t hear when there’s noise in the background. If they’re sitting in a restaurant with friends or family and they’re not catching the conversation – but when they’re home and it’s one-on-one and their fine – it’s time to figure out why. When the spouse tells someone they’re losing their hearing, and that person says, “No, you just talk low,” that’s generally a sign you should get a hearing test. Or if someone says, “He doesn’t hear me when I call from another room anymore,” that’s a sign. Directionality is big.

 

Source: http://buffalonews.com/2016/03/12/amherst-ent-antibiotics-are-treatment-of-choice-for-ear-infections/