Ear infection and sore throat are common conditions in both adults and children. Bacteria or viruses mainly cause ear and throat infections. Therefore, the use of antibiotics in treating Ear and throat infection is based on whether the infection is caused by bacteria(s) or not. The right antibiotic drug is prescribed to treat a sore throat or ear infection if the infection is caused by bacteria (Shrotriya & Kochar, 2018).

According to the Centers for Disease Control and Prevention (CDC), over 100 million antibiotic prescriptions are written every year in the ambulatory setting. With numerous such prescription written annually, wrong application or use of antibiotics may promote resistance. Besides antibiotics prescribes for upper respiratory tract infections caused by viruses, broad-spectrum antibiotics are in most cases used in a situation that narrow-spectrum antibiotic would have been effective. The use of antibiotic has resulted in the development of antibiotic-resistant bacteria (CDC, 2019).

, and for children, it starts after a child has a cold, sore throat or upper respiratory infection. In the event that the upper respiratory infection is caused by bacteria, the bacteria might spread to the middle ear; in the event that the infection is due to virus, such as cold, bacteria might spread to environment favoring microbe survival and multiplications and then spread to middle ear as secondary infection (CDC, 2019). The infection cause fluids to accumulate behind the eardrum (Shrotriya & Kochar, 2018).

Based on the set guidelines, people with acute otitis media, which is a middle ear infection common in young people and children. About one in four kids suffer middle ear infection before reaching 10 years and about 60-percent shows improvement signs within one day even without taking antibiotics. As a result, children and young people with middle ear infections should be given painkillers rather than antibiotics (Shrotriya & Kochar, 2018). The guidelines for using antibiotics is critical in helping in preventing antibiotic resistance

Based on the healthcare treatment guidelines, antibiotics are used to treat babies with an ear infection. Children aged 6 months to 24 months should also be treated with antibiotics in the event they have an ear infection (Shrotriya & Kochar, 2018). A child with severe symptoms including fever of more than 102.2F or extreme pain requires treatment with an antibiotic.  In addition, antibiotics can be used to treat children with chronic disease in the event of ear infection and this includes kids having a cleft palate, immune system complications, cochlear implant or Down syndrome. The child who has chronic ear infection also should be treated using antibiotics (Shrotriya & Kochar, 2018).  Healthy older kids do not require antibiotics for treating an ear infection as soon as the diagnosis is made, they must be monitored for about 48-72 hours. If the symptoms fail persists or worsen then antibiotic can be administered. At first pain, relief drug such as ibuprofen or acetaminophen is offered (CDC, 2019).  If after 48-72 hours the pain fails to go away, and the fever of the child remains above 102.2F a child may require intramuscular or intravenous antibiotics such as ceftriaxone (Rocephin). Children below six months with severe symptoms will have to stay in medication for 10 days while older kids will be under medication for 5-7 days.  Amoxicillin is prescribed for acute otitis media when the condition worsen unless the kid has been under amoxicillin in the past one month, the child has parallel purulent conjunctivitis, the child has a history of acute otitis media unresponsive to amoxicillin or the child is allergic to penicillin (CDC, 2019). Prophylactic antibiotics should not be employed to alleviate the frequency of episodes of recurrent acute otitis media in kids.  Tympanostomy tubes might be provided for acute otitis media recurrent three episodes in six months or 4 episodes in 12 months with episode in the past six months (Shrotriya & Kochar, 2018).

Sore throats are also infection caused by viruses or bacteria. People normally recover quickly approximately 3 or 4 days, even though some might develop complications (Aertgeerts, 2017).  Rheumatic fever is an example of a serious, however rare complication which affects joints and heart. Antibiotics minimize bacterial infection but have some side effects such as rash, vomiting, or diarrhea and other adverse effects (Greens, 2015; Rodríguez & Barcenilla, 2015). Patients with less severe symptoms of sore throats should not be given antibiotics. When prescribing an antibiotic for people aged 18 years and above with sore throat, the first alternative is Phenoxymethylpenicillin, which should be given 500 mg 4-times a day, or 1000 mg two times a day for 5-10 days if the patient is allergic to the drug then alternative, which is Clarithromycin, given 250 mg to 500 mg twice a day for 5 days, or Erythromycin given 250 mg – 500 mg 4-times a day or 500 mg -1,000 mg 2-times day for 5 days. For young people under 18 years and children, Phenoxymethylpenicillin for children 1-11 months is 62.5 mg 4-times a day or 125 mg two-times day for 5-10 days. For children 1- 5 years, 125 mg 4-times a day or 250 mg twice a day for 5-10 days. For children 6-11 years, 250 mg 4-times a day or 500 mg 2-times a day for 5-10 days. For children aged 12-17 years, 500 mg 4-times a day or 1,000 mg 2-times a day for 5-10 days  (Razai & Hussain, 2017; Van Driel et al., 2018).

For the alternative prescription, Clarithromycin can be provided with children aged 1 month to 11 years:

• Under 8 kg, 7.5 mg 2-times a day for 5 days
• 8 – 11 kg, 62.5 mg 2-times a day for 5 days
• 12-19 kg, 125 mg 2-times a day for 5 days;
• 20 -29 kg, 187.5 mg 2-times a day for 5 days,
• And 30 -40 kg, 250 mg 2-times a day for 5 days (Razai & Hussain, 2017).

For 12-17 years 250 mg to 500 mg 2-times a day for 5 days.

For Erythromycin prescription:

• 1 month-1 year, 125 mg 4-times a day or 250 mg 2-times a day for 5 days
• 2-7 years, 250 mg 4-times a day or 500 mg 2-times a day for 5 days
• 8 -17 years, 250 mg to 500 mg 4-times a day or 500 mg to 1000 mg 2-times a day for 5 days

References

Aertgeerts, B. (2017). Corticosteroids for sore throat: a clinical practice guideline. BMJ, j5654. doi: 10.1136/bmj.j5654

CDC. (2019). Adult Treatment Recommendations | Community | Antibiotic Use | CDC. Retrieved from https://www.cdc.gov/antibiotic-use/community/for-hcp/outpatient-hcp/adult-treatment-rec.html

Green, S. (2015). Assessment and management of acute sore throat. Practice Nursing, 26(10), 480-486. doi: 10.12968/pnur.2015.26.10.480

Razai, M., & Hussain, K. (2017). Improving antimicrobial prescribing practice for sore throat symptoms in a general practice setting. BMJ quality improvement reports, 6(1), u211706.w4738. doi:10.1136/bmjquality.u211706.w4738

Rodríguez, A., & Barcenilla, F. (2015). Nebulized antibiotics. An adequate option for treating ventilator-associated respiratory infection?. Medicina Intensiva (English Edition), 39(2), 97-100. doi: 10.1016/j.medine.2015.02.001

Shrotriya, R., & Kochar, A. (2018). Assessment of Efficacy of Anthroposophic and Conventional Treatment with Antibiotics in Children with Acute Respiratory or Ear Infections: A Prospective Study. Annals Of International Medical And Dental Research, 4(2). doi: 10.21276/aimdr.2018.4.2.pe3

Van Driel, M., Scheire, S., Deckx, L., Gevaert, P., & De Sutter, A. (2018). What treatments are effective for common cold in adults and children?. BMJ, k3786. doi: 10.1136/bmj.k3786