What is an ear infection?
The term ear infection refers to an infection in any part of the ear by any type of disease-causing organism. Otitis externa is an infection of the outer ear, meaning any part of the ear outward from the tympanic membrane (eardrum). Otitis media is an infection of the middle ear, the part of the ear that contains three tiny bones that transmit vibration from the tympanic membrane to the inner ear and that contains the Eustachian tube, which connects the ear to the back of the mouth and throat. Otitis interna is an inner ear infection, more commonly called labyrinthitis. Usually, when you hear about an ear infection it refers to otitis media caused by a bacterial agent, and that is the focus of this report.
How common is ear infection during pregnancy?
Otitis media is a common infection in children, but roughly 15 percent of cases occur in adults, so the condition can co-exist with pregnancy. The most common bacterial species causing this infection are Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis.
How is otitis media diagnosed?
Otitis media is diagnosed based on your history and physical exam, which would show an earache, fever, and often upper respiratory tract symptoms such as a runny nose from a cold. You may hear ringing in your ears and experience vertigo, which means that you feel as if you are moving or the world is spinning. The doctor will examine the tympanic membrane of your ear with an otoscope to look for fluid, bulging, redness, and other signs that your middle ear is inflamed. Your hearing and balance will be checked, and the doctor may also want to use a very small needle to pierce the tympanic membrane to collect fluid to send for laboratory testing to determine which bacterial species is causing the infection. Since the hole that is pierced is very tiny, it will close up within a few days without harming your ability to hear.
Does an ear infection cause problems during pregnancy?
Middle ear infections can cause a high fever, which can lead to dehydration and problems, sometimes long-term problems, in various organ systems. You also can experience problems with hearing and balance (vertigo).
Does an ear infection during pregnancy cause problems for the baby?
A high fever due to a bacterial infection in your ear possibly can lead to problems for the developing baby. Some studies have suggested that fever during pregnancy can increase a babys risk of having congenital defects involving the heart and other organs. Also, a recent study identified maternal fever as a possible risk for the baby developing autism spectrum disorder.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the ear infection
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat ear infections during pregnancy?
There are a few different antibiotic regimens for treating ear infection, and the course of antibiotics can run for up to 14 days, depending on which regimen the doctor selects. One approach is to use amoxicillin-clavulanate, while another is to use trimethoprim-sulfamethoxazole. These are fairly safe during pregnancy, but there is some controversy surrounding sulfonamide drugs. If you do take trimethoprim-sulfamethoxazole, you need to be diligent about taking supplemental folic acid during the first trimester (this is something that you should do anyway during pregnancy).
There are three main categories of antipyretic (fever-fighting) drugs. One group consists of acetaminophen in the United States and paracetamol in several other countries. Another group is called non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, naproxen, and many others. Along with being antipyretic, NSAIDs also reduce inflammation. The third group, called salicylates, includes aspirin, which technically is also a kind of NSAID, because it reduces inflammation. There is concern that NSAIDs and salicylates may be harmful to the developing baby, but acetaminophen and paracetamol are thought to be safe.
Meclizine is a drug that you may be offered to treat vertigo. Although there used to be some concern that this drug might harm the developing baby, it now is considered to be fairly safe.
Who should NOT stop taking medication for an ear infection during pregnancy?
It is important for anyone who is given antibiotics for otitis media to complete the prescribed regimen. Most pregnant women who need acetaminophen or paracetamol to eliminate fever during pregnancy should not stop taking the drug, because there is concern that fever could be harmful to the developing baby. The exception is for women who have liver problems, but having liver problems in the first place already makes successful pregnancy very challenging.
What should I know about choosing a medication for my ear infection during pregnancy?
You may find Pregistrys expert reports about the individual medications to treat ear infections here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for my ear infection when I am breastfeeding?
Most of the antibiotics given for otitis media are fairly safe during breastfeeding. Acetaminophen, paracetamol, and NSAIDs are thought to be relatively safe in mothers who breastfeed. Meclizine has not been studied extensively in terms of levels that can accumulate in breastmilk and what it could do to an infant, but generally, the concern is very low that it could cause a problem.
What alternative therapies besides medications can I use to treat my ear infection during pregnancy?
For people with recurrent ear infections, special tubes can be placed surgically to keep pressure from building up in the middle ear.
What can I do for myself and my baby when I have an ear infection during pregnancy?
Complete the entire course of your antibiotic regimen as directed and get plenty of rest.
Resources for ear infection in pregnancy:
For more information about ear infection during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles: