Brief Answer:
Information

Detailed Answer:

Hello,

I will assume the Zithromax was given for bacterial bronchitis or sinusitis? Regarding the ears, when there is an upper respiratory infection with drainage down the back of the throat, ears can get congested and sometimes infected.

If they have a bacterial infection, the azithromycin should clear it up.

But often the problem is not due to a bacterial infection but rather a eustachian tube dysfunction and retracted ear drum, sometimes with clear fluid behind it. The eustachian tubes connect the throat with the middle ears. When fluid goes down the throat from drainage from the sinuses, it creates a vacuum effect in the middle ear with negative pressure, pulling the ear drum in, which creates a muffled kind of sound. If serous (clear) fluid develops in the middle ear, sometimes people hear crackling or even dripping. This is sometimes visible when looking in the ear - the eardrum is pulled in and doesn't move well with an air puff, and sometimes a fluid level is seen or clear bubbles.

So what to do about it: Treating the drainage down the throat can help. You can try a decongestant such as pseudoephedrine, to help dry things up, but just use it for a few days. You can also try a steroid nasal spray to try to stabilize the mucus membranes of the sinuses. If none of that works, sometimes ENT doctors will prescribe a short course of oral steroids to try to decrease inflammation.

Eventually, it will go away, and there is no other treatment that has been proven to be superior or 100 per cent effective, but you can try these and they may help.

If you smoke cigarettes, now is the time to quit, as it will prolong recovery from infections and increase the chance of complication.

I hope this information helps. Please let me know if I can provide further information.

Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician

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Brief Answer:
Thoughts on this

Detailed Answer:

Hi,

I would recommend

1. Try the nasal fluticasone first as it is much safer than starting the oral steroids without first discussing whether you need it. Oral steroids have more side effects and risk systemically.

2. Zithromax is pretty good at killing most pathological respiratory bacteria. It stays in one's system for several days after taking the short course of it. If you have a Z-pack, I recommend continuing it until it is finished. While we usually see some improvement in the first 24-48 hours, it can take longer for the infection and symptoms to fully resolve.

3. Rather than adding the leftover oral methyl pred without first getting checked by your doctor, I recommend adding in the decongestant pseudoephedrine.

4. If none of that works, then go in to see your doctor - but know that it can take a few weeks (unfortunately) for the ear symptoms to resolve, even after the respiratory infection has cleared up.

Hope I have answered your query.

Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician

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