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Treatments and drugs
By Mayo Clinic staffMany cases of ear infection don't need treatment such as antibiotics. What's best for your child depends on many factors, including your child's age, medical history and the type of ear infection.
A wait-and-see approach
Before prescribing antibiotics, most doctors will wait to see if the infection clears up on its own. The American Academy of Pediatrics and the American Academy of Family Physicians recommend a wait-and-see approach for the first 72 hours for children who:
- Are older than age 6 months
- Are otherwise healthy
- Have mild signs and symptoms or an uncertain diagnosis
Most ear infections clear on their own in just a few days — and antibiotics won't help an infection caused by a virus. In fact, about 80 percent of children with middle ear infections recover without antibiotics. Adults' ear infections also may clear on their own.
Your family doctor or pediatrician may recommend an over-the-counter pain reliever such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) to help with the pain from the infection.
If your child doesn't have drainage from the ear or ear tubes, prescription eardrops containing numbing medication may be an option, too. The drops won't cure the infection, but they may relieve pain. Warm the drops slightly by placing the bottle containing the drops in warm water. Then gently lay your child on a flat surface with his or her infected ear facing up. Don't give the drops with your child in your arms or on your lap.
Antibiotic therapy
Treatment with antibiotics is recommended for each of these groups of people:
- Children younger than 6 months old
- Children and adults who have had two or more ear infections in the past 30 days
Some doctors believe people who have otitis media with effusion (OME) should also be given antibiotics. However, it's not universally agreed that antibiotics are necessary or will work to prevent an ear infection for people with OME.
The first choice antibiotic of many doctors is amoxicillin, although other antibiotics are effective if you or your child is allergic to amoxicillin.
If the medication is effective, you or your child should start feeling better in a few days. Be sure to take the antibiotic for the full length of the prescription. Stopping medication too soon could allow the infection to come back.
Remember, antibiotics won't help an infection caused by a virus — and the overuse of antibiotics contributes to strains of the bacteria that resist these medications. Side effects from the medications — such as vomiting, diarrhea and allergic reactions — are possible as well.
Drainage tubes
If fluid in your child's ear is affecting his or her hearing or recurrent ear infections don't respond to antibiotics, your child's doctor may suggest surgery. Surgery is not a common treatment for adults.
The most common surgery for ear infections is a myringotomy and the insertion of tubes in your child's ears. During this procedure, which requires general anesthesia, a surgeon inserts a small drainage tube through your child's eardrum. This helps drain the fluid and equalize the pressure between the middle ear and outer ear.
Your child's hearing should improve immediately. As your child grows, the tubes normally will come out on their own and the drainage holes will heal — often within a year. In the meantime, your child may need to wear special earplugs in the pool and bathtub to keep water out of his or her ears.
Some children continue to have ear infections after surgery. Sometimes this leads to another set of tubes. If the ear infections continue after age 4, the surgeon may recommend removing your child's adenoids.
