Ear infections are no fun for anyone.

An ear infection (otitis media) occurs when fluid builds up behind your eardrum in the middle part of your ear and causes swelling (inflammation). This can lead to significant pain and discomfort.

Since most ear infections are caused by bacteria, it’s typically best to treat individual cases with antibiotics.

But antibiotic treatment isn’t appropriate for every ear infection. There are a variety of factors to consider, including:

  • causes
  • severity
  • location of infection
  • your age

Recurring ear infections may also require a different approach.

If you’re considering ear infection antibiotics for yourself or a loved one, learn more about how these medications work and how they can be both helpful and possibly harmful.

Ear infections are most prevalent in young children. They’re often the byproducts of upper respiratory infections.

You or your child might experience other symptoms before the ear infection, including:

If an upper respiratory infection is caused by bacteria, then it’s possible to have an ear infection at the same time.

An ear infection occurs when bacteria gets trapped in your middle ear. Bacteria known as Hemophilus influenza and Streptococcus pneumoniae are the most common bacterial culprits.

But an ear infection may still occur if you have a viral respiratory illness. As you recover, it’s possible for bacteria to travel to your middle ear and become trapped, leading to a secondary infection in your ears.

Types of ear infections

The most common type of ear infection is called acute otitis media (AOM).

AOM infections

AOM is more common in children because they have smaller eustachian tubes. Located between the middle ear and upper throat, these tubes are responsible for fluid drainage.

If this fluid doesn’t drain, a buildup and infection may occur. Fluid trapped in the middle ear behind your eardrum may also cause:

Other common infections

Other common types of ear infections include:

When antibiotics are used

Antibiotics are typically only prescribed for AOM.

OME and COME occur after an infection has already occurred. Antibiotics can’t treat fluid buildup if there’s no active infection.

An antibiotic may be prescribed for an active ear infection once your doctor has examined your ear and has determined you exhibit signs and symptoms of AOM or swimmer’s ear.

Frequent or recurring ear infections should also be addressed with a doctor. Due to concerns with antibiotic resistance, recurring ear infections or COME shouldn’t always be treated with antibiotics.

Depending on the severity of your ear infection, your doctor may hold off on prescribing antibiotics.

Antibiotic resistance

Depending on the circumstance, your doctor may hold off on prescribing antibiotics to help prevent the possibility of antibiotic resistance.

Biofilms

Another possible risk factor for antibiotic treatments of chronic ear infections is the development of biofilms. These antibiotic-resistant bacteria colonies tend to develop in children who have recurring AOM.

Avoiding side effects

The Centers for Disease Control and Prevention (CDC) recommends waiting up to 3 days to see if a mild ear infection clears up on its own.

If an infection is either severe or still active after 2 to 3 days, your doctor may decide to prescribe antibiotics.

Healthline

A mild ear infection may go away on its own. But most cases of moderate to severe ear pain require a visit to your doctor. You should also see your doctor if you’re experiencing ear discharge, fever, or chills.

Children with ear infections may constantly cry due to pain and discomfort. They might also tug or pull at the affected ear. See your doctor if symptoms don’t improve within 2 to 3 days, or if they get worse.

Other signs that you should see a pediatrician include:

If your child has recently had a cold, you should be on the lookout for signs or symptoms of an ear infection.

Once you’re at the doctor’s office, a medical professional will look inside your ear with an otoscope to determine whether you have an infection.

Typical signs include fluid buildup in the ear canal and middle ear, along with a red and inflamed eardrum.

Depending on the severity of your symptoms, your doctor may recommend waiting a few days to see if your ear infection improves.

Some infections resolve on their own. But if the infection is severe, or if symptoms don’t improve after this time, then antibiotics may be warranted.

Chronic fluid buildup without an infection warrants additional testing from an ear, nose, and throat (ENT) specialist.

It’s especially important to diagnose young children so that they don’t encounter speech and language delays from loss of hearing.

If your doctor recommends antibiotics to treat a severe ear infection, they will likely recommend an oral treatment, such as amoxicillin (Amoxil).

Antibiotic ear drops

Antibiotic ear dropsmay be prescribed, especially for the treatment of swimmer’s ear.

Oral antibiotics

Oral antibiotics are typically prescribed for 7 to 10 days.

Be sure to finish your prescription. Even if you feel better after a few days, the infection may return if you stop taking your medication.

Talk to your doctor about other antibiotics you’ve taken in the past and whether they’ve worked or not. Symptoms that don’t improve within 3 days may need other treatments.

New ear infection treatments

A research team at Boston Children’s Hospital created an antibiotic gel for ear infections that can be inserted directly into the ear canal.

They tested the gel in chinchillas and found that it may reduce treatment time and antibiotic resistance. However, more research needs to be done in human subjects.

Healthline

OTC pain relievers

In addition to prescribed antibiotics, your doctor may recommend an over-the-counter (OTC) pain reliever to help reduce fever, pain, and overall discomfort.

OTC pain relievers include acetaminophen (Tylenol) and ibuprofen (Advil). Check with your pediatrician about the correct dosage for your child. Don’t give ibuprofen to children younger than 6 months of age.

Your doctor may ask you to come in for a follow-up visit to ensure that the infection has completely cleared. Fluid may remain in your ear for several weeks after the infection is gone.

If you have hearing or balance problems, see your doctor.

Warning: Don’t give aspirin to children to treat ear or other viral infections

Don’t give aspirin to a child or teen unless specifically recommended by a doctor.

Taking aspirin to treat an ear infection increases the risk of Reye’s syndrome. This rare disorder usually occurs in children who have had a recent viral infection.

Healthline

In some cases: surgery

Ear infections often go away with time or with the help of antibiotics. However, some people may experience recurrent ear infections and fluid buildup, or have ear infections that won’t heal for months.

In children, these issues can lead to hearing loss, behavioral issues, and speech development delays.

In these instances, a surgery called a tympanoplasty may help. In this procedure, a doctor inserts tiny tubes, called tympanostomy tubes or grommets, into the eardrum. These tubes reduce the occurrence of ear infections and allow drainage of excess fluids.

The procedure is very common and poses minimal risks. An ear tube insertion is more common for children, who tend to suffer ear infections more often than adults.

Home treatments for ear infections may be considered for mild cases in adults only.

Homeopathic pain relief

Some remedies, such as OTC homeopathic pain relief drops, have shown some promise to help alleviate pain and discomfort.

Acupuncture

Research has also shown that acupuncture may be helpful for some people. But more clinical studies are needed.

Herbal remedies

Some herbal remedies may interact with medications, so be sure to talk to your doctor before trying to use them to treat an ear infection.

Never take herbal remedies by mouth for an ear infection, and avoid such remedies in children.

Other preventative measures

If you or your child struggles with recurring ear infections, talk to your doctor about preventive measures. Some options might include:

Antibiotics can help treat an ear infection. But doctors are increasingly reserving them for severe cases only. This can help decrease the occurrence of antibiotic resistance.

Whether you take antibiotics or not, stay in touch with your doctor regarding your condition. Symptoms that don’t improve or become more severe may require follow-up treatments.