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A painful, inflamed eardrum—or two—is something many people have had the misfortune of experiencing at least once before. Ear infections aren’t pleasant and can cause serious issues besides ear pain, such as hearing loss or a ruptured eardrum. Ear infections are common in young children, but people of all ages can get them. Luckily, there are effective treatments.
What is an ear infection?
Otitis, or ear infections, is a condition that causes inflammation of the ear. It can occur in the middle ear, inner ear, or outer ear and can take on a few different variations depending on the specific type of infection that occurs. Some forms are referred to as a swimmer’s ear, otitis media, or labyrinthitis. The most common ear infection symptoms are pain in the ear as well as a fever, sore throat, or fussiness in children. Ear infections can be common in children so it’s important to know what non-verbal symptoms to look for and when to seek medical attention.
How is an ear infection diagnosed?
Patients who experience ear infections should seek medical attention if they (or those caring for them) are concerned with the severity or type of ear infection. Ear infections are common and can often be caused by many different factors.
A viral infection is the most common cause of an inner ear infection whereas outer ear infections are usually caused by bacteria. Middle ear infections can be a result of bacterial infections, a virus, or other illness like a cold, flu, or allergies.
Fortunately, there are steps that you can take to prevent ear infections. “[Use] earplugs if swimming in freshwater, do not use q tips, hairpins, or other sharp objects in the ear canal, keep [and] use decongestant when congested from cold,” says Inna Husain, MD, an otolaryngologist and assistant professor at Rush University Medical Center in Chicago.
Ear infections are diagnosed by performing a physical examination. A primary healthcare professional, family physician, or ear, nose, and throat doctor (ENT) may inspect the ears for infection using a tool such as an otoscope, which blows a puff of air into the ear. If the eardrum doesn’t move, the patient could have fluid buildup. Depending on the type of ear infection, the doctor may also check for symptoms of an ear infection such as a fever or drainage of the ear. The healthcare professional may also ask questions about certain risk factors pertaining to ear infections, which might include:
- Age: Infants who drink from a bottle may have more ear infections than breastfed babies. Children are more susceptible to ear infections, as their immune systems develop. Children in daycare or school-aged kids are more likely to contract illnesses from other children, which could lead to ear infection.
- Air quality: Second-hand smoke and other pollutants can increase the risk of infection.
- Allergies: Pollen can trigger allergies and put people at risk for an ear infection.
- Cool weather: Upper respiratory infections are more common in the fall and winter seasons, which can result in earaches and infection.
Ear infection treatment options
Due to the variety of ear infections, patients may be given a few different treatment options. Middle ear infections do not always require prescription medication due to the body’s natural ability to fight off the infection. Your doctor or pediatrician may recommend a method of treatment called watchful waiting. This involves two to three days of rest, drinking lots of fluids, and the use of over-the-counter pain relievers as needed. If after two to three days the patient is not improving, the doctor may write a prescription for antibiotics. Alternatively, the physician may write a prescription for an antibiotic but recommend waiting two to three days before filling in case the ear infection clears up in the meantime.
In some cases, using a tympanostomy tube (commonly called ear tubes) may be necessary to prevent fluid from building up in the ear and to assist with relieving air pressure near the eustachian tube.
Ear infection medicines
Analgesics
This drug class is commonly used to treat the pain associated with ear infections. While this drug class will not clear or cure the ear infection itself, using an analgesic can alleviate pain in the ear. The most commonly used analgesic is Tylenol (acetaminophen), which is available over-the-counter. Side effects of acetaminophen can include nausea, vomiting, or stomach pain.
Nonsteroidal anti-inflammatory drugs
Also known as NSAIDs, these medications are used similarly to analgesics. While nonsteroidal anti-inflammatory drugs will not cure ear infections, they will provide pain relief. The most commonly used NSAID is ibuprofen, however, it is typically only recommended for children 6 months or older. Side effects of ibuprofen can include nausea, dizziness, and constipation.
Antibiotics
Penicillin is the most commonly prescribed medication for treating ear infections. Penicillin antibiotics are typically prescribed by doctors after waiting to see if the infection clears on its own. The most commonly prescribed penicillin antibiotic is amoxicillin. Side effects of amoxicillin can include nausea, vomiting, and rash.
Sometimes doctors will prescribe other types of antibiotics depending on the type or severity of the infection. These other antibiotics may include clarithromycin, cefpodoxime, and azithromycin.
What is the best medicine for ear infections?
| Drug name | Drug class | Administration route | Standard dosage | Common side effects |
| Children’s Tylenol (Children's acetaminophen) | Analgesic | Oral | Solution form is based on the age and weight of child | Nausea, vomiting, stomach pain |
| Advil or Motrin (ibuprofen) | NSAID | Oral | 200-400 mg every 4-6 hours as needed (ask a doctor before giving ibuprofen to a child) | Nausea, dizziness, constipation |
| Amoxicillin | Penicillin antibiotic | Oral | Infants older than 2 months and children: 80 to 90 mg/kg/day twice daily. In adults, 500 mg tablet taken twice daily with/without food | Nausea, vomiting, headache |
| Biaxin (clarithromycin) | Antibiotic | Oral | In infants, children, and adolescents: 15 mg/kg/day twice daily. In adults, 500 mg taken every 8-12 hours | Diarrhea, nausea, stomach pain |
| Vantin (cefpodoxime) | Antibiotic | Oral | In children, usually 5 mg/kg/dose every 12 hours. In adults, 200 mg tablet every 12 hours | Nausea, vomiting, stomach pain |
| Zithromax (azithromycin) | Antibiotic | Oral | Usually, it is not recommended due to increased resistance. 1 tablet taken once per day. | Nausea, headache, vomiting |
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are common side effects of ear infection medicine?
All medications can cause side effects that vary in type and severity. Remember that every patient is different and may experience different side effects for their specific treatment. All patients should consult their primary healthcare provider before starting medication for treating otitis as well as if any side effects persist or worsen. The following is not a complete list. Common side effects of ear infection medicine can include:
- Nausea
- Headache
- Vomiting
- Stomach pain
- Constipation
- Diarrhea
- Dizziness
- Rash
What are the best home remedies for ear infections?
Since watchful waiting is a fairly common approach to treating ear infections, home remedies are popular for treating this common condition. There are many different sworn methods out there for treating everything from the earache or ear pain to the infection itself. However, it is important to remember that if untreated by a medical professional, some ear infections can result in a worsening condition such as a ruptured eardrum or hearing loss. Some of the commonly used home remedies for ear infections include:
- Cold or warm compress: Using a cold or warm compress on the affected ear can help reduce inflammation and alleviate pain. Patients may notice more success by alternating between both a cold compress and warm compress every 10 minutes or so. However, simply using one or the other should make some difference in the condition.
- Changes to sleep positions: Some ear infections are made worse by sleeping in a way that irritates the affected ear. By sleeping with the infected ear raised instead of down it can help relieve pressure and may allow it to drain more easily or prevent fluid buildup.
- Olive oil: While it is an older remedy, olive oil is said to have some soothing properties. It is used by putting just a few warmed drops in the patient’s ear. It may have some soothing benefits. However, given that it isn’t a studied treatment for ear infections it might be a better option to use in combination with other home remedies.
Frequently asked questions about ear infections
Do ear infections clear up on their own?
Some ear infections may clear on their own. Middle ear infections are often cured by the body’s immune system when left alone. However, inner and outer infections may require medication. If patients are experiencing more than just the common symptoms of ear infections then they should seek medical attention.
Can you treat an ear infection without a doctor?
It is possible to treat some types of ear infections without help from a doctor. A middle ear infection may clear up on its own without going to the doctor. Outer ear and inner ear infections may require medical attention depending on the severity of the infection and the body’s ability to fight the infection. Common home remedies and treatments include the use of over-the-counter pain relievers, cold or warm compresses, changes in sleeping positions, and olive oil.
Can you get over an ear infection without antibiotics?
Not all ear infections require the use of antibiotics for treatment, especially acute otitis media (or a middle ear infection). Medical treatment or antibiotics may be necessary in cases of persistent symptoms or severe ear pain.
How long does it take for an ear infection to heal?
On average, an ear infection can last one to two weeks depending on where it is located and how it is treated. Middle ear infections tend to go away the fastest without treatment. Inner ear infections can last a few weeks. The use of antibiotics or other treatment methods can help speed up the healing process.
How do you get rid of an ear infection fast?
A combination of antibiotics with home remedies may help to get rid of an ear infection quickly. However, on average, an ear infection can last for one to two weeks.
What is the best antibiotic for ear infections?
The most commonly prescribed antibiotic for ear infections is amoxicillin. Although, there are other antibiotics prescribed if amoxicillin is not an option.
Can you get antibiotic eardrops over the counter?
Antibiotic drops are a prescription-only medication. You can get eardrops over-the-counter for cleaning and sterilizing ears, however, they may not be as strong or effective as prescription-only antibiotic eardrops.
How effective is doxycycline for treating an ear infection?
Doxycycline may be prescribed for bacterial ear infections or earaches resulting from a sinus infection.
How do you treat a middle ear infection?
A middle ear infection, or otitis media, is typically treated at first using a watchful waiting method. After the watchful waiting period, if the infection has not cleared then a prescription for antibiotics is required.
How do you treat an outer ear infection?
An outer ear infection (otitis externa or swimmer’s ear) is most often treated with antibiotic ear drops prescribed by a doctor. These drops will be used several times a day for seven to 10 days, depending on how the infection responds to treatment.