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Ear Infections: To Tube or Not?

It's bad enough having to watch your little guy suffer through one ear infection, let alone bout after painful bout.

Implanting ear tubes can significantly reduce and often eliminate infections for at least six months (they allow infections to drain and be easily treated with antibiotic drops). Still, it requires surgery. So how do you decide whether the procedure is right for your child? Grab a pen and take the mini-quiz below, designed with the help of Marcella Bothwell, M.D., a pediatric otolaryngologist at Rady Children's Hospital in San Diego:

1. How many times has your doctor prescribed antibiotics for ear infections?
A. Fewer than three times in six months, or fewer than four times in one year (Add 0 points)
B. Three or more times in six months, or four or more times in one year (Add 3 points)

2. How old is your child?
A. Over 2 (Add 1 point )
B. Under 2 (Add 2 points)

3. What kind of antibiotics has your child taken?
A. Only first-line antibiotics, such as amoxicillin or Zithromax (Add 1 point)
B. Broad-spectrum antibiotics, like Augmentin and Rocephin (Add 2 points)

4. Is your child in daycare?
A. No (Add 0 points)
B. Yes (Add 1 point)

Total score _______

To tube or not to tube?

Less than 3 points: It's very unlikely that ear tubes are appropriate for your child. He hasn't had multiple recurrent infections, which is the bare-minimum requirement for surgery. This is good news!

3 to 6 points: Your child may benefit from the procedure, especially if he's already been nabbed several times in the past year and has needed heavier-duty drugs to beat the bacteria. Both of those experiences suggest he is at higher risk for developing a resistant bug later. On the other hand, if your child has had only a couple of bouts that healed easily with mild antibiotics like penicillin, your doctor may suggest taking a watch-and-wait approach. The odds of picking up a hard-to-treat infection in the future are lower than for other children.

7 to 8 points: Tubes may give your honey welcome relief. He's likely already suffered significant pain and many sleepless nights; there's a good chance he has also already required stronger and stronger medicine to kick the infections. Kids in this category are generally under 2 and/or in daycare: They're exposed to more bacteria than other children, and their immature immune systems have a harder time fighting them. Share your findings with your doctor. Together you'll be able to come up with the best plan for your little one.