Hello doctor, My daughter is 5 years old. Last month, we noticed that she had pain in her right ear and the thing continued for three to four days. On 5th, we noticed lots of wax in her right ear. It seemed to be pus. So, we took her to an ear specialist. After diagnosis, the doctor told us that her ear is infected. But he could not investigate the ear well as my daughter was scared and she did not let the doctor investigate the ear properly. Then the doctor advised the following medicines for her:  Syrup Fimoxyclav 100 ml 1.5 teaspoon (1+1+1) for seven days. Syrup Telfast 1 teaspoon (1+0+1) for seven days. Candibiotic ear drops three to four drops in right ear three times daily for seven days. Rynex nasal drop 0.025 % two to three drops in both nose holes three times for seven days.  As per the doctor's prescription, we started the medicine. But we cannot use the Rynex because my daughter did not let us use it in her nose. But her ear condition was improving and after ten days, we went to the doctor again. The doctor investigated her (this time also my doctor did not let the doctor to check properly) ear and told us that she is now fine. After several days, my daughter again told us that she is feeling pain in her ear. But this time, not in the right ear but in the left ear. We took her to her regular pediatric doctor. Actually, she went to visit her grandma on summer vacation and that is why we took her to this doctor. Doctor investigated her and he could check her both ears well. My daughter knows this doctor very well, so she let him check the ear well. As per the doctor, her right ear is fully alright but left ear is infected. So, he suggested the following medicines:  Syrup Renova two teaspoons two times daily, if there is any fever more than 100 F. But till now, we did not observe any. Syrup Cefim 3DS one teaspoon every 12 hours for 10 days. Syrup Brodil 1.5 teaspoon every 8 hours for 10 days. Tablet Ritch 60 for 15 days. Rynex nasal drop 0.025 %.  Then, the doctor asked us to visit him again after 10 days. In this period, her ear was improving but it seems to us that her ear has not recovered properly and also we noticed that when we give nasal drop both her ears were getting wet. After 10 days, we visited the doctor again. He told us that her punctured right ear has not yet fully recovered. So, he extended the medicine Cefim 3DS for another for four days. And also asked us if again infection occur to do the following tests.  Ear swab C/S. Urine R/M/E.  However, after that, we did not see any visible infection yet, but her both ear seem wet to us. So, we did his recommended tests. Please find the test report from the attachment. Her test report shows that her ear is infected by Staphylococcus aureus. And I came to know that this bacteria is very much dangerous as this has resistivity for most of the antibiotics. So, I am very scared of now. Could you please let us know her real status?
Hello. Ear infections in children are very common. Children have a straight and wide eustachian tube that helps throat microbes to reach the ear easily and cause infection. So whenever she has a chest infection or throat pain or cold or flu, there are chances that her ears will also get infected. Once the ears get infected, then subsequently more chances that throat and nose infections will go up to the ear. Once ear gets infected, it is very painful and pus is produced inside. The pus breaks open the eardrum and come outside. Thereafter with medicines and the body's immunity, the ear condition resolves. But the hole in the eardrum does not close very soon. It takes a few weeks. During this time, water should not go into the ear while bathing or swimming, etc. You should take care that your daughter does not insert any cotton or match stick or anything inside the ear. Talking about the medicines given by ENT doctor and the pediatrician, both are almost the same. They both have given a different set of antibiotics and the pediatrician has added Salbutamol, which is mostly because your daughter might have been having chest problem or wheezing while going to him. Talking about staphylococcus, it is a dangerous organism when it becomes resistant to common antibiotics. Many times, it is a commensal in our body, commensal meaning routine organism. In the C/S report that you have attached (attachment removed to protect patient identity), the organism is sensitive to Ciprofloxacin. I suggest you instill two drops of Ciplox (Ciprofloxacin) in either ear thrice daily for a week and continue the medicines that the doctor has asked you to. Continue Antihistaminic medicine (Telfast) for two weeks. Go back to your ENT after that time and ask him to put an otoscope and check both ears. Tell your daughter to be bold and friendly and bribe her with chocolates so that the doctor is able to look into the ear and tell you clearly what it is. If possible ask the doctor to show the findings using an oto-endoscope which can be connected to the TV screen and shown to all including your daughter. Till then the precautions you take are: 1. No water inside the ear. 2. Can apply the drops I suggested. 3. Do not continue nasal drops (ENT drops or pediatrician drops) for more than four days in continuity (it can cause other nasal problems) 4. If she develops throat or nose problem, immediately show her to ENT and take adequate treatment. 5. Avoid cold foods and juices, give homemade juices and home cooked food. 6. Avoid excessive sun, dust, and dehydration. Talking about the reasons for frequent nose and throat infections, she could be having tonsillar enlargement and frequent inflammations. With your next query, please take a picture of your daughter's open mouth showing details of tonsils and back of the throat so that we can assess if there is a tonsillar problem which may need some other treatment. Do revert back to me for further information and any help. For more information consult an ENT otolaryngologist online -->