Provided by Erica Glancy, MD

I developed a rash while taking amoxicillin for a childhood ear infection. I was told to avoid all penicillins because I might be allergic. Am I likely to have an allergy to penicillin? 

The penicillin family of antibiotics includes over a dozen chemically-related drugs, one common example being amoxicillin. Immediate allergic reactions to these antibiotics typically occur quickly after receiving a dose, and often include skin symptoms, such as hives. Labels of penicillin allergy are commonly attached in childhood with up to 10% of the population being labeled as penicillin allergic. Fortunately, over 90% of these individuals will actually be able to tolerate penicillin drugs. 

Why do so many people think they are allergic to penicillin if they really aren’t? 

Two potential reasons for the discrepancy between reported penicillin allergy and the ability to tolerate penicillin drugs are the mislabeling of side effects of penicillin as true allergies (e.g. stomach upset) and the occurrence of coincident events that aren’t actually due to allergy (e.g. hives related to the illness for which the antibiotic is being prescribed). Another very important factor is the loss of allergy with avoidance over time. Even in those with true allergy, over 90% will lose sensitivity over a 10 year period. 

Provided by Darryl Willett, MD

Pediatric Tonsillectomy and Adenoidectomy (known as a T&A) is the second most common pediatric surgical procedure performed. There may be a variety of reasons your child might be referred to one of our Ear, Nose and Throat Specialists here at Ohio ENT and Allergy Physicians.

The more common reasons to be referred by your child’s Pediatrician, Family Physician or Dentist are: chronic tonsillitis (or strep throat), snoring, obstructive sleep apnea (where your child has pauses in their nighttime breathing, breath holding and gasping episodes), swallowing problems where they appear to be choking on food, chronic halitosis (bad breath), and chronic mouth breathing which can lead to misaligned teeth.

Complications are uncommon, but fewer than 1% of children can have bleeding after surgery. Most of the time, this is self-limiting and nothing further needs to be done, but on a rare occasion, your child may need to go back to surgery to have the bleeding stopped. Most children should expect to miss 1 week of school to recover.

Provided by Michael J. Loochtan, MD

Ear infections are one of the most common disorders to that affect children. These can often be managed with medication without the need for further intervention. Sometimes, however, your child’s doctor may recommend that your child have an evaluation with an otolaryngologist. Below is an explanation of what ENTs are, a discussion of normal ear anatomy, and an explanation of when ear infections may warrant consideration for ear tube placement.

An ENT is a doctor who is specially trained to diagnose and treat disorders of the ears, nose, and throat medically or surgically if needed. Therefore, they are also called head & neck surgeons. It’s a mouthful to say “Otolaryngologist – Head & Neck Surgeon” therefore usually we just go by “ENT.” ENT training is quite rigorous and entails 4 years of medical school after college, followed by 5 years of residency training. Some ENTs pursue additional specialized training after residency. This extra training is called a fellowship and is usually 1-2 years in length.

Provided by Evan Tobin, MD
and Roger Friedman, MD

If your child has tried antihistamines and/or nasal steroids but their symptoms did not improve, the pediatrician may send a referral to a specialist.

Which specialist? An Allergist or an ENT (Ear, Nose and Throat)?

At Ohio ENT & Allergy Physicians, both specialties work together to sort these problems out.  At one of our 10 convenient locations, a pediatric patient with chronic nasal and sinus symptoms can be evaluated for both adenoid problems and allergies. Testing will include routine allergy testing, a thorough physical exam and sometimes the use of a small flexible endoscope to evaluate the nasal passages and check the size of the adenoids. This scope also allows diagnosis of other problems such as a nasal foreign body, a polyp, or a deviated nasal septum (which is rare in children).

Medical treatment may be tried again by our specialists. This may include stronger nasal sprays, antihistamines, antibiotics or allergy shots (immunotherapy).

If this treatment is still not effective, surgical treatment may be offered. This may include removal of the adenoids and treatment of the nasal swellings called “turbinates”.  Sometimes tonsillectomy or ear tube insertion may be necessary, as well. (These will be discussed in a future blog.)

Provided by Evan Tobin, MD
and Roger Friedman, MD

Young children are more susceptible to upper respiratory infections (aka “URI” or “common cold”) because they are still growing, their immune systems are still maturing, and they are exposed to more viral infections through daycare and early school years.

The symptoms of a cold are well known to all of us. The symptoms include cough, runny nose, nasal congestion and sometimes a low-grade fever.

Some children, however, seem to have a “never ending cold”. They may mouth breathe, snore loudly and have a constant runny nose.

  • What is the cause for these symptoms?
  • As a parent, should you be concerned?
  • What can be done?

Two common problems of childhood can explain these nasal symptoms that simply won’t go away.

  1. Allergies
  2. An enlargement or infection of the adenoids

There are similarities between these two conditions. Both can cause chronic congestion and runny nose. These two problems can also overlap, both being present in the same patient.  If left untreated, the child may develop sleep and behavior problems and alteration in facial or dental development from long-term mouth-breathing.

Provided by David Hauswirth, MD

What is the difference between immunotherapy (IT) and rush immunotherapy?

Immunotherapy is a treatment for allergies.  The patient is given gradually increasing doses of a substance they are allergic to, trying to make them tolerant or not allergic.  For all types, the length of treatment is the same, typically 3-5 years.  The difference between “rush” and traditional immunotherapy is the buildup phase.  There are typically two phases to immunotherapy, build-up and maintenance. 

With “rush” immunotherapy, the build-up is accomplished in a rapid fashion.  Usually the patient will come into the office for a half or a whole day and receive many shots trying to build up more quickly.  There is a much higher risk of a systemic reaction with this type of treatment.  Rush is different from traditional build-up with weekly injections.  A third type is cluster immunotherapy with the patient receiving a few shots each visit trying to build a little faster.

Does rush immunotherapy work better than immunotherapy?

All of the immunotherapy styles have the same efficacy.  The only difference is how quickly you reach the maintenance dose.  A patient on rush, a patient on cluster and a patient on traditional immunotherapy will still be on the treatment for 3-5 years and will have the same outcome, regardless of the build-up schedule.