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Forum Name: Pediatric Topics

Question: Recurring Ear Infections 6 year old


 MamaT - Sun Nov 18, 2007 11:37 am

My son is age 6 years and has already had 3 sets of grommets, the first being at age 2 and the last being August 2006. In the last month he has had a few ear infections and completed 2 x 5 day course of Zinnat. The ears are not that much better. The grommets have come out naturally. Today I had 2 different ENT's tell me 2 different things.

The first one: Not a bacterial infection, prescribed 5 day course of Predeslone 3ml x 2 per day, and Garasone drops , 2 drops 3x per day. The leaflet in the drops says that there are no tests done on children under 8.

The 2nd ENT: It is bacterial as there is puss and brownish/black puss from the ear. Prescribed Zithromax 7.5ml x 1 per day for 3 days and Ciprobay HC Otic, 2 drops, 3 times per day. This dr said that Garasone should not be given to children, especially with grommets due to the toxicity.

Please can you advice. My son has a low grade temperature and it spikes in the evening to over 38 dregrees celcius. I give him Lotem for the pain and fever.

He does have allergies and has Aerius 5ml at night and Nasonex nasal spray.

Many thanks
Concerned mother
 Dr. Chan Lowe - Sat Nov 24, 2007 11:43 pm

User avatar Hi MamaT,

You are correct that garasone is not approved for use with children less than eight years old. Unfortunately, many medications that are used in children are not approved by the FDA because there are not many formal studies on medications in children.

Garasone contains two medicines, gentamicin (an antibiotic) and betamethasone (a steroid). This is a common combination for ear drops, an antibiotic and a steroid. I have used gentamicin ear drops frequently. Betamethasone is a relatively strong steroid. In ear drops for children I have not used this medicine. Instead, I tend to use hydrocortisone, a much weaker steroid.

Azithromycin (Zithromax) is an antibiotic that may or may not be an appropriate choice for ear infections. Most ear infections are caused by a bacteria called streptococcus pneumoniae (about 75% or so). In many areas, azithromycin is only effective against strep pneumo about 50% of the time. This is dependent upon the statistics for your area. I would recommend you talk with your doctor about this. If resistance is not an issue in your area then azithromycin is a reasonable choice.

Unfortunately, I cannot give you any solid information. My advice is only based on my experience, not good evidence.

I would recommend you discuss these two options with your son's pediatrician. This will allow you to get some perspective from a doctor that knows your son and his history.

Best wishes.

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