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Ear Infection Questions

If an ear examination shows redness on the eardrum, in addition to a persistent fever (ranges from 100.3-103.9 taken rectally)  that is not relieved at all by Tylenol (child is 5.5 months old), is antibiotics (Omnicef) the ideal next step?  I thought Amoxicillin is always prescribed when it's the first time a baby is introduced to antibiotics.  Will the antibiotic help to relieve the fever?

Proper ear exams in pediatric patients are not easy. As a doctor (and as a parents), we want the ear to look either completely normal or absolutely infected. Unfortunately, ear drums often look “pretty good” or “somewhat red”. While doctors often report redness to parents, it is the yellow bulging pus filled ear drums that are definitely infected. Redness is often an early sign of ear infections, but can be the result of patient crying.

Typically, the first antibiotic used for ear infections is Amoxicillin. It is cheap, effective and patients like the taste. There are many factors that effect antibiotic choice. I often use Omnicef (cefdinir) for a few special situations. I used Omnicef when families are traveling as it a rare antibiotic that does not require refrigeration. I use Omnicef when patient resist and fight taking medicines as it tastes great and is only once a day. I will also use Omnicef if the patient has both ear and eye infections simultaneously. These combined infections are typically the caused by the bacteria Haemophilus influenza which responds better to Omnicef than Amoxicillin.

After 24 to 48 hours of therapy the antibiotic should reduce the child’s symptoms. If the child has fever or ear pain beyond 48 hours of antibiotics they should call their doctor.


Written January 2011 by
Dr. Gordon, Windermere Pediatrician


 is intended to help parents understand the needs and behaviors of children. The information presented in the site is the opinion of Gregory Gordon, M.D.and does not reflect the opinion of his partners. This website is owned exclusively by Doctors insights LLC. The advice in this site does not apply to all children. Always consult your healthcare provider for your individual needs.

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