Commonest cause of earache is otitis media for which you need an otoscope to diagnose. If the infection is in the ear canal, it is so painful that child won’t let you touch his/her ears.
If there is no infection of the ear canal or the middle ear chances are that ear ache is a referred pain from the throat, due to an infection or ulcer in that area. Often the parents on the advice of family and friends put oil in the ear canal.This oil or even medicated drops mix with the wax which is already present in the canal and block the vision of the doctor, who cannot see the tympanic membrane and hence cannot daignose correctly. Advise analgesic like ibuprofen or paracetamol by mouth to relieve the pain. If pain is severe, one may further advise a mild sedative to reduce the discomfort. Now a days, fewer case of acute otitis media are seen due to increased rates of vaccination.
Commonest cause of otitis media is infection caused by H.Influenzae, pneumococcal or Moraxella catarrhalis. Commonest antibiotic effective against all three is Amoxicillin with Clavulanic acid for 7-10 days. However in milder cases of otitis media you need not give any antibiotics and only observe. Oral decongestents or nose drop are of no use in otitis media.
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