What to look for if you suspect an ear infection after tubes

There is a canal called the eustachian tube that connects the middle ear to the back of the throat. The eustachian tube helps to equalize air pressure outside of the body. An infant's eustachian tube is shorter and narrower and is positioned more horizontal than an adult's. Because of this, throat and nose secretions (and any germs they may be harboring) travel more easily through it. If the child has a cold, sore throat, allergies, or sinus infection, this tube can become blocked. This causes fluid and bacteria that would normally drain to get trapped. The trapped bacteria becomes a middle ear infection.

If fluid remains in the ear even after treatment or ear infections are frequent, a doctor may recommend inserting a tympanostomy tube ("ear tube") to help equalize the air pressure, drain the fluid, and prevent the collection of fluid from the middle ear.

A bacterial middle ear infection, also known as acute otitis media with tympanostomy tubes (AOMT), may occur at some point after ear tube insertion. AOMT is different from an ear infection in a child without ear tubes. Below are some helpful images that show what an ear infection looks like, both with and without ear tubes, and may help you determine if your child has an ear infection.

Inside close up view of a healthy eardrum
Normal, healthy eardrum without tubes

(view requires the use of medical tools by your healthcare provider)

Inside close up view of a swollen and inflamed infected eardrum
Middle ear infection without tubes

(view requires the use of medical tools by your healthcare provider)

Close up view of a plastic tube, called a tympanostomy tube, inserted in middle of eardrum
Inner view of healthy ear with tubes

(view requires the use of medical tools by your healthcare provider)

Outer view of ear - the tympanostomy tube is not visible
Outer view of healthy ear with tubes
Outer view of yellow discharge from an infected ear
Outer view of infected ear with tubes
Unhappy infant tugging on ear, a possible sign of an ear infection
Nonverbal signs of infection

▼ IMPORTANT SAFETY INFORMATION

Do not use OTOVEL if your child:

  • Is allergic to quinolones including ciprofloxacin, corticosteroids including fluocinolone acetonide, or any of the ingredients in OTOVEL.

  • Has an outer ear canal infection caused by certain viruses including chicken pox (varicella) and the herpes simplex virus, or has a fungal ear infection.

INDICATIONS

OTOVEL® (ciprofloxacin and fluocinolone acetonide) is used in children 6 months of age and older, who have a tiny cylinder tube in their eardrum known as a tympanostomy tube to prevent excess fluid in the middle ear. Otovel is used to treat a type of middle ear infection called acute otitis media with tympanostomy tubes (AOMT) caused by certain bacteria.

IMPORTANT SAFETY INFORMATION

Do not use OTOVEL if your child:

  • Is allergic to quinolones including ciprofloxacin, corticosteroids including fluocinolone acetonide, or any of the ingredients in OTOVEL.

  • Has an outer ear canal infection caused by certain viruses including chicken pox (varicella) and the herpes simplex virus, or has a fungal ear infection.

Before using OTOVEL, tell your healthcare provider about all of your child’s medical conditions, including if they:

  • Are pregnant or plan to become pregnant, although OTOVEL is not expected to harm the baby.

  • Are breastfeeding or plan to breastfeed, although OTOVEL is not expected to pass into the breast milk to harm the baby.

Tell your healthcare provider about all the medicines your child takes, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Use OTOVEL exactly as your healthcare provider tells you. OTOVEL is for use in the ear only. Do not inject OTOVEL or use OTOVEL in the eye. If symptoms do not improve after 7 days of treatment with OTOVEL, contact your healthcare provider. Do not use OTOVEL for a condition for which it was not prescribed. Do not give OTOVEL to other people, even if they have the same symptoms. It may harm them.

Call your healthcare provider right away if:

  • Fluid continues to drain from the ear after finishing treatment with OTOVEL.

  • Fluid drains from the ear 2 or more times within 6 months after treatment has stopped.

OTOVEL may cause serious side effects, including allergic reactions. Stop using OTOVEL and contact your healthcare provider if any of the following signs or symptoms of an allergic reaction occur: hives, swelling of your face, lips, mouth, or tongue, rash, itching, trouble breathing, dizziness, fast heartbeat, or pounding in your chest.

The most common side effects of OTOVEL include fluid draining from the ear, ear infection, ear itching, extra tissue that grows on a part of your body that has been injured, swelling of the outer part of the ear, ear pain, or balance problems.

Tell your healthcare provider of any side effects that are bothersome or that do not go away. These are not all the possible side effects of OTOVEL. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. For more information, ask your healthcare provider or pharmacist, or consult the full Prescribing Information.