How is otitis media (middle ear infection) treated?

Many middle ear infections will get better on their own, while some need to be treated with an antibiotic. Your doctor will decide if your child needs to be treated with an antibiotic for an ear infection. Permanent damage to the ear or to the hearing is very rare.

Treatments include the following:

  • Observation without antibiotics: Your doctor may determine that your child has a middle ear infection but does not need to be treated with antibiotics (depending on the age of your child and how severe the infection is). Many ear infections will get better on their own without antibiotic treatment. Your doctor will tell you how long the symptoms will last.
  • Antibiotics: Antibiotics, prescribed by your doctor, may be needed to kill the bacteria that are causing the ear infection. Do not forget to take or give it in regular doses until the bottle is empty, even if the pain and fever are gone. Finishing the medicine will keep the ear infection from flaring up again. Follow the instructions on the prescription about proper storage and the proper dose. Use a measuring spoon for liquid antibiotics to be sure that you give the right amount. Call the doctor if fever and pain are not gone within two days of starting the antibiotics. Antibiotics may cause nausea, diarrhea, rashes, or yeast infections, and may also interact with other medications. Rarely, allergic reactions can occur. There is the potential that bacteria will, over time, develop a resistance to frequently used antibiotics. Be sure to tell your doctor about your medical history and any over-the-counter and prescription medications that you are currently taking.
  • Pain relief: Acetaminophen or ibuprofen can help relieve earache or fever until the antibiotic takes effect. These medications usually control the pain within one to two hours. Earaches tend to hurt more at bedtime. Using a warm compress on the outside of the ear may also help relieve pain. (This is not recommended for infants.)
  • Restrictions: The ears do not need to be covered when going outside. Swimming is okay as long as there is no perforation (tear) in the eardrum or drainage from the ear. Air travel or a trip to the mountains is safe, although temporary pain is possible during takeoff and landing. Swallowing fluids, chewing on gum during descent, or having a child suck on a pacifier will help relieve discomfort during air travel. Children can return to school or day care as soon as the fever is gone. Ear infections are not contagious.
  • Myringotomy: If fluid remains in the ear for more than three months, your doctor may want to insert small metal or plastic tubes through the eardrum to equalize pressure between the middle and outer ear. This outpatient procedure (myringotomy) is usually performed on children and can be done under general anesthesia. The tubes will remain in from 6 to 12 months and normally fall out on their own. The outer ear will need to be kept dry and free of water until the holes have closed completely.

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