I am trying to wrap my head around the treatment of middle ear infections in children, since my toddler is having a lot of these, and there doesn't seem to be a clear cut solution.
So far I have learned the following:
- There was a time when acute middle ear infection (the type you don't expect will heal on its own) was mostly treated surgically by an incision in the eardrum and optionally tubes in addition.
- In more modern times, antibiotics have gained popularity as a first-line treatment and surgery is reserved for cases, where antibiotics fail.
- The main worry about middle ear infections, is permanent damage to the ear and hearing loss. However, data seems to suggest, that antibiotics treatment does not appear to statistically reduce this type of complication (I am not sure if this is actually true).
- The second most important urgency factor is temporary hearing loss, which may hinder speech development.
- Some data seems to suggest, that the "tubes" solution, doesn't appear to be very effective.
- Antibiotics can be applied intranasally, via a cream or internally. Some doctors prescribe anti-viral nasal drops, while others don't. Some prescribe ear drops, others don't.
- Some people believe, that using a ultra-red lamp may help with this condition.
- Surgery is not a permanent solution, but only a solution to drain the ear. Future infections may require repeat surgical procedures.
I have visited a bunch of doctors, and have anecdotally observed the following patterns:
- Old Scool doctors in economically underdeveloped neighborhoods seem to be quick on the surgery trigger.
- Less old school, but in no way very forward thinking doctors seem to rely on internal antibiotics.
- Private doctors, or doctors, who are on the "cutting edge" are more likely to prescribe an antibiotic cream and or ear/nose drops over internal antibiotics.
So in conclusion, the therapy seems to have changed from routine surgery to heavy-handed use of antibiotics, to less heavy-handed use of antibiotics in combination with other remedies.
Since I am not a doctor, I may be completely wrong, and of course, every tool has its purpose, but I am asking about the general trend here.
What is the most current understanding, about how such infections should be tackled by physicians? What is the most "cutting edge" idea at the moment?
Am I correct in thinking, that over time, the approach has become more "hands-off", than in the past?
Please feel free to make suggestions on how to make this question better. I am trying to find out, what the most modern approach here is. Please also feel free to correct me on my list of assumptions.