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Otitis media - acute; Infection - inner ear; Middle ear infection - acute
Some ear infections will safely clear up on their own without antibiotics. Often, treating the pain and allowing the body time to heal itself is all that is needed:
All children younger than 6 months with a fever or symptoms should see the doctor. Children who are older than 6 months may be watched at home if they do not have:
If there is no improvement or symptoms get worse, schedule an appointment with your health care provider to determine whether antibiotics are needed.
A virus or bacteria can cause ear infections. Antibiotics will not help an infection caused by a virus. Many health care providers no longer prescribe antibiotics for every ear infection. However, all children younger than 6 months with an ear infection are treated with antibiotics.
Your health care provider is more likely to prescribe antibiotics if:
Make sure you or your child takes the antibiotics every day and finishes all the medicine, rather than stopping when symptoms go away. If the antibiotics do not seem to be working within 48 to 72 hours, contact your doctor. You may need to switch to a different antibiotic.
Amoxicillin is commonly the first choice. Other antibiotics that may be given are azithromycin or clarithromycin, cefdinir, cefuroxime, cefpodoxime, amoxicillin clavulanate (Augmentin), clindamycin, or ceftriaxone.
Side effects of antibiotics include nausea, vomiting, and diarrhea. Although rare, serious allergic reactions may also occur.
Some children who have repeat infections that seem to go away in between may receive a smaller, daily dose of antibiotics to prevent new infections.
If an infection does not go away with the usual medical treatment, or if a child has many ear infections over a short period of time, the doctor may recommend ear tubes.
If the adenoids are enlarged, surgical removal of the adenoids may be considered, especially if you continue to have ear infections. Removing tonsils does not seem to help with ear infections.
Ear infections can be treated but may occur again in the future. They can be quite painful. If you or your child are prescribed an antibiotic, it is important to finish all your medication as instructed.
Generally, an ear infection is a minor medical problem that gets better without complications. Most children will have minor, short-term hearing loss during and right after an ear infection. This is due to fluid lingering in the ear.
Rarely, a more serious infection may develop, such as
Fluid can remain behind the eardrums even after the infection has cleared for weeks or even months.. See also: Otitis media with effusion
Other potential complications include:
Call your child's doctor if:
For a child younger than 6 months, let the doctor know right away if the child has a fever, even if no other symptoms are present.
Tähtinen PA, Laine MK, Huovinen P, Jalava J, Ruuskanen O, Ruohola A. A placebo-controlled trial of antimicrobial treatment for acute otitis media. N Engl J Med. 2011 Jan 13;364(2):116-26.
Hoberman A, Paradise JL, Rockette HE, Shaikh N, Wald ER, Kearney DH, et al. Treatment of acute otitis media in children under 2 years of age. N Engl J Med. 2011 Jan 13;364(2):105-15.
Coker TR, Chan LS, Newberry SJ, Limbos MA, Suttorp MJ, Shekelle PG, et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis mediain children: a systematic review. JAMA. 2010 Nov 17;304(19):2161-9.
Koopman L, Hoes AW, Glasziou PP, Cees L, Appelman L, Burke P, et al. Antibiotic therapy to prevent the development of asymptomatic middle ear effusion in children with acute otitis media: a meta-analysis of individual patient data. Arch Otolaryngol Head Neck Surg. 2008;134:128-132.
Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years---United States, 2011. MMWR. 2011;60(5).
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