Dr. Narasimharaju. B. G
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 9-year-old son is having throbbing and shooting pain in the right ear. He has been crying for the past two hours. I put Otek AC drops in his ear, but there was no use. He got such pain three years back. Can you please guide me?
Hello,
Welcome to icliniq.com.
I need you to answer a few questions: 1) Does he have a cold? I mean, running nose? 2) If yes, how many days? 3) Is the pain sudden in onset? 4) Had he had such episodes before?
Patient's Query
Thank you doctor,
He says it was a sudden onset within one hour when he tried to stop himself from sneezing while taking a bath. He has had a cold for a few days. He had an episode three years back where he had ear pain. Currently, we have put him on Ibugesic syrup once in about 12 hours. But whenever the Ibugesic effect is gone, that is after 12 hours, and he experiences pain ever since the problem started two days back. Now, the pain seems to have radiated from the ear also to include the temple area, cheek area, and throat area. Please advise me on this.
Hello,
Welcome back to icliniq.com.
He should probably have started developing ASOM (acute suppurative otitis media) pus in the ear. He has had a cold for two days, so he probably pushed the infection from nose to ear through the Eustachian tube, which connects the nose and the middle ear. I suggest you start him on the following antibiotics: 1. Tablet Augmentin (Amoxicillin and Potassium Clavulanate) 375 mg, six tablets two times a day. 2. Tablet Sinarest (Caffeine, Chlorpheniramine, Paracetamol, and Phenylephrine), nine tablets three times a day. 3. Tablet Levocetirizine 5 mg, six tablets two times a day. If he is not comfortable with tablets, then you can give him the following: 1. Syrup Augmentin (Amoxicillin and Clavulanic Acid) DS 5 mL two times a day. 2. Syrup Sinarest (Chlorpheniramine, Phenylephrine, Paracetamol, and Sodium Citrate) 5 mL three times a day. 3. Syrup Levocetirizine 5 mL two times a day. 4. Nosikind P Nasal Spray drops two drops three times a day in both nostrils. With these medications, he should also take steam inhalation.
Patient's Query
Thank you doctor,
The ASOM condition does not heal itself on its own? Is antibiotic usage is a must?
Hello,
Welcome back to icliniq.com.
If it is ASOM (acute suppurative otitis media), it has stages. 1. Stage of tubal occlusion. 2. Stage of pre-suppuratiom. 3. Stage of suppuration. 4. Stage of resolution. 5. Stage of complications. If stage four does not occur, it will go into stage five. In stages one and two, it can come down with only antihistamines and painkillers. But this is only a chance. When risk versus benefit is weighed, it is better to give antibiotics. If suppuration occurs, it will create a hole in the tympanic membrane, and pus will start coming from the ear. If such a thing happens, then whenever the child catches cold or water enters into his ear for example, while taking a bath or swimming, then his ear will start oozing pus. So my advice is better to take all the medications, including antibiotics.
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Otolaryngology (E.N.T)
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