Ear Infection Treatments and Medications

Otitis means there is inflammation in the ear. It can occur in the outer ear (otitis externa, also called swimmer’s ear), the middle ear (acute otitis media), or the inner ear (labyrinthitis). The most common ear infection symptoms are ear pain, fever, sore throat, or fussiness in children. Ear infections aren’t pleasant by any means and can cause serious issues besides ear pain, such as hearing loss or a ruptured eardrum. Although most clear up with rest, fluids, and pain relievers, stubborn or severe cases may need to be evaluated by a healthcare provider.

How is an ear infection diagnosed?

Ear infections are diagnosed by physical examination of the ears. A healthcare provider, a family physician, or an ear, nose, and throat doctor (ENT) can usually diagnose an ear infection with a quick exam. They’ll look inside the ear with an otoscope to check for signs of redness, fluid, or drainage. They may also ask about:

• Age. Infants, toddlers, and bottle-fed babies are more likely to get ear infections than older children and breastfed infants.

• Recent illness. Colds, flu, and seasonal allergies may increase the risk of middle ear infections.

• Water exposure. Swimming can sometimes lead to trapped water in the outer ear canal, which may increase the risk of swimmer’s ear.

• Environment. Secondhand smoke and other airborne irritants increase risk.

Fortunately, patients and parents can take steps to prevent infection, including “[Use] earplugs if swimming in freshwater, do not use Q tips, hairpins, or other sharp objects in the ear canal, keep, [and] use a decongestant when congested from cold,” says Inna Husain, MD, an otolaryngologist and assistant professor at Rush University Medical Center in Chicago.

Ear infection treatment options

Most ear infections can easily be treated and may even get better on their own. For an uncomplicated middle ear infection, healthcare providers may recommend watchful waiting, which means taking 48 to 72 hours for rest, fluids, and OTC medicines to see if the body clears it. If symptoms don’t improve, they may prescribe an antibiotic. Children with recurring middle ear infections or fluid behind the eardrum for more than three months might need tympanostomy tubes (ear tubes).

Types of ear infection medication

Depending on the type of ear infection, your healthcare provider may recommend over-the-counter pain relievers, oral antibiotics, or antibiotic ear drops.

Pain relievers

Analgesics are commonly used to treat pain associated with ear infections. However, analgesics will not clear or cure the ear infection. The most commonly used analgesic is Tylenol, which is available over the counter. Side effects of Tylenol are rare at normal doses but may include nausea or stomach pain. 

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs, also known as NSAIDs, are used similarly to analgesics. The difference is that analgesics help with pain and fever, while NSAIDs help with pain, fever, and inflammation. While nonsteroidal anti-inflammatory drugs will not cure ear infections, they may help relieve pain. The most commonly used NSAID is ibuprofen, known by the brand names Advil and Motrin. However, it is typically only recommended for children 6 months or older. Side effects of ibuprofen can include nausea, an upset stomach, and dizziness.

RELATED: Is it safe to take ibuprofen and Tylenol together?

Antibiotics

Penicillin-type antibiotics are the most commonly prescribed drug class for treating bacterial middle ear infections. The first-line antibiotic for these infections is amoxicillin or a combination of amoxicillin and clavulanate known as Augmentin. Side effects can include nausea, vomiting, and rash. Sometimes, healthcare providers prescribe other types of antibiotics depending on the type or severity of the infection (as well as if the patient has any allergies to penicillin). These other antibiotics may include cefdinir, cefuroxime, and doxycycline. 

Antibiotic ear drops

Topical antibiotic ear drops are usually a first-line option for swimmer’s ear or for children with drainage in their ear tubes. Topical drops alone may be preferred over oral antibiotics in these situations since they’re often more effective at the site of infection and cause less antibiotic resistance. Common options include Ciprodex (ciprofloxacin-dexamethasone) and Cipro HC (ciprofloxacin-hydrocortisone). Side effects may include discomfort or ear irritation.

Over-the-counter ear infection medicine

No OTC product is available that can cure an ear infection. Instead, a pain reliever like Tylenol or Advil can help manage the ear pain and fever. Aspirin should be avoided in children due to the risk of Reye’s syndrome. Decongestants and antihistamines are no longer recommended for ear infections since they don’t shorten the infection and can cause side effects.

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