Azithromycin For Ear Infection: Does It Work, Dosage, and Side Effects

In this article, we will take a close look at ear infections, also known as otitis media, and the role of azithromycin in their treatment. We will explore the causes, symptoms, and side effects of ear infections and understand how Azithromycin works to combat these infections. We will also discuss the potential risks associated with Azithromycin treatment.
Jakub Gwiazdecki

Jakub Gwiazdecki

Fifth year medical student at the Medical Faculty of Comenius University in Bratislava.

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What is an Ear Infection, and How Does it Develop?

An ear infection, or otitis media, is an inflammation of the middle ear. It can be caused by bacteria or viruses. Otitis media is especially common in children. During childhood, about 8 in 10 children will develop this condition, with most of the cases occurring in the first 3 years of life [1, 2, 3].

The pathogenesis of ear infections often involves the occlusion of the eustachian tube, a small canal between the ear and the throat. When its lumen is blocked, fluid can build up in the middle part of the ear, giving a substrate for the pathogens to grow on. Usually, the obstruction occurs during colds, sinusitis, or allergies [1, 4].

Another reason for an ear infection can be the spreading of the causative agent from an infected adenoid close to the Eustachian tube [1].

Early in life, the eustachian canal is quite short and narrow. This is the direct cause of the high prevalence of otitis media in children. An additional increase in the risk of ear infection is caused by bottle-fed babies. When a baby lies flat, the channel between the throat and the ear is more likely to get obstructed with the milk formula [5].

Other risk factors for otitis media are:

  • altitude changes,
  • changes in temperature and humidity,
  • cigarette smoke,
  • male sex,
  • low birth weight [1]

What are the Symptoms of an Ear Infection?

Depending on the type and severity of the infection, otitis can have many manifestations.

A common symptom is pain inside the ear. It can be experienced along with a persistent feeling of increased pressure in the ear [1].

During an infection, fluid discharge can also be seen. The solution can accumulate in the ear, leading to obstruction of the ear canal. This can restrict the hearing [1].

Additionally, ear infections can cause headaches, nausea, problems with imbalance, or dizziness [5].

In some cases, particularly when the infection is severe, systemic symptoms can also be present. They include severe pain and fever [1].

Babies with otitis can be observed to lose appetite, become restless, and pull or manipulate around the ear [1]. In some cases, they can also experience diarrhea and vomiting [6].

What is azithromycin, and how does it work?

Azithromycin belongs to macrolides, a group of bacteriostatic antibiotics. This means that it stops bacterial proliferation and multiplication. It does so by inhibiting bacterial protein synthesis.

Azithromycin can be used in the treatment of various types of infections, among which are ear infections. It is an antibiotic that works effectively against bacteria like Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis [8, 9, 10, 7, 11, 12].

Azithromycin has shown effectiveness in treating acute otitis media in children. In one study, 98% of azithromycin treated patients showed cure or improvement in signs and symptoms.

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Jakub Gwiazdecki

Jakub Gwiazdecki

Jakub is in his fifth year as a medical student at Comenius University in Bratislava, Slovakia. He has special interested in cardiology and in patient-centered medicine. His love for heart health isn't just book-smarts; he wants to know how it works, what it means for our feelings, and how key it is for health and happiness. Jakub thinks real good health care comes from always putting the patient at the centre, treating each person as a whole.