Although ear infections commonly affect young children, people of any age can get them. They can cause symptoms like ear pain, fever, sore throat, and—in children—fussiness.
An ear infection can occur in the middle ear, inner ear, or outer ear.
Middle ear infections caused by bacteria may require antibiotics—or watchful waiting, which means waiting a few days to see if the immune system clears the infection before taking antibiotics.
Over-the-counter medicines like Tylenol (acetaminophen) or Motrin (ibuprofen) can help with ear pain but will not cure an infection.
Consult your healthcare provider for more information and medical advice on ear infections.
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 by any means and can cause serious issues besides ear pain, such as hearing loss or a ruptured eardrum. Ear infections are often associated with young children, but people of all ages are at risk of getting them at some point. Let’s take a look at what causes ear infections and how they can be treated.
Otitis means that there is inflammation in a part of the ear. It can occur in the middle ear, inner ear, or outer ear and can take on a few variations depending on the specific type of infection. 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.
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 result from bacterial infections, viruses, or other illnesses like colds, flu, or allergies.
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 infections are diagnosed by examining the ears. A primary healthcare professional, family physician, or ear, nose, and throat doctor (ENT) may inspect the ears for infection using a tool called an otoscope to look inside the ears. The doctor can check for symptoms of an ear infection, such as 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 are more likely to get ear infections than breastfed babies. Children, especially infants and toddlers, are more susceptible to ear infections as their immune systems are still developing. Children in daycare or school-aged kids are more likely to contract illnesses from other children, which could lead to ear infections.
Air quality: Secondhand 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 infections.
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 because the body’s immune system can often fight off an infection. The doctor or pediatrician may recommend 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 the patient is not doing better after two to three days, the doctor may write a prescription for antibiotics. Alternatively, the physician may prescribe an antibiotic but recommend waiting two to three days before filling in case the ear infection clears up in the meantime.
In some cases, such as with frequent middle ear infections, tympanostomy tubes (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.
This drug class is commonly used to treat the pain associated with ear infections. While analgesics will not clear or cure the ear infection, they 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, 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 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.
RELATED: Is it safe to take ibuprofen and Tylenol together?
Penicillin-type antibiotics are the most commonly prescribed drug class for treating bacterial ear infections. Doctors typically prescribe penicillin antibiotics after waiting to see if the infection clears on its own. The most commonly prescribed penicillin antibiotics are amoxicillin or Augmentin (amoxicillin/clavulanate). Side effects can include nausea, vomiting, and rash.
Sometimes, doctors will prescribe other types of antibiotics depending on the type or severity of the infection (as well as if the patient has any allergies to medicines). These other antibiotics may include cefdinir, cefuroxime, or doxycycline. In some cases, healthcare providers may prescribe antibiotic ear drops instead of oral antibiotics.
| Drug name | Learn more | See SingleCare price |
|---|---|---|
| Amoxicillin | amoxicillin details | Get free coupon |
| Augmentin | augmentin details | Get free coupon |
| Cefdinir | cefdinir details | Get free coupon |
| Cefuroxime Sodium | cefuroxime-sodium details | Get free coupon |
| Cefpodoxime | cefpodoxime-proxetil details | Get free coupon |
| Doxycycline Hyclate | doxycycline-hyclate details | Get free coupon |
| Zithromax | zithromax details | Get free coupon |
| Azithromycin | azithromycin details | Get free coupon |
All medications can cause side effects that vary in type and severity. Remember that every patient is different and may experience different side effects from their specific treatment. All patients should consult their primary healthcare provider before starting medication to treat otitis and if any side effects persist or worsen. The following is not a complete list. Common side effects of ear infection antibiotics can include:
Nausea
Headache
Vomiting
Stomach pain
Constipation
Diarrhea
Dizziness
Rash
Since watchful waiting is a fairly common approach to treating ear infections, home remedies are popular for treating this common condition. There are many sworn methods for treating everything from earache or ear pain to infection. However, it is important to remember that if left 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 cold and warm compresses every 10 or so minutes. 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. Sleeping with the infected ear raised instead of lying on it can help relieve pressure and allow it to drain more easily or prevent fluid buildup.
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 quickest without treatment, and inner ear infections can sometimes last a few weeks. The use of antibiotics, when necessary, can help speed up the healing process.
Ear infections themselves are not contagious. However, the viruses or bacteria that cause them are often contagious. To help prevent the spread of germs, it’s important to practice good hygiene, such as washing hands frequently and disinfecting shared items or surfaces.
Some ear infections may clear on their own. Middle ear infections are often fought off by the body’s immune system when left alone. However, inner and outer infections may require medication to clear up. If you or your child is experiencing ear pain, it is a good idea to see a healthcare provider so they can determine if you have an ear infection.
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, thanks to the body’s immune system response. Outer ear and inner ear infections may require more medical attention depending on the severity of the infection and the body’s ability to fight it. Common home remedies and treatments include over-the-counter pain relievers, cold or warm compresses, and changes in sleeping positions.
Not all ear infections require 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.
If the infection is caused by bacteria, a combination of antibiotics with home remedy methods may help get rid of an ear infection fast. However, on average, an ear infection can last for one to two weeks. See a healthcare provider for an appropriate diagnosis and treatment.
Amoxicillin or Augmentin are the most commonly prescribed antibiotics for ear infections, although other antibiotics can also be prescribed if necessary.
Antibiotic eardrops are prescription-only medications. There are no antibiotic eardrops available over the counter.
Doxycycline may be prescribed for bacterial ear infections or earaches resulting from a sinus infection. It is sometimes used when the patient is allergic to penicillin-type antibiotics.
A middle ear infection, or otitis media, is typically treated first using a watchful waiting method. If the infection has not cleared after the watchful waiting period, an antibiotic prescription is given.
An outer ear infection (otitis externa or swimmer’s ear) is most often treated with antibiotic ear drops prescribed by a doctor. These drops are used several times a day for seven to ten days, depending on how the infection responds to treatment.
Acute otitis media in adults, UpToDate
Ear infection basics, Centers for Disease Control and Prevention
Ear infections, MedlinePlus
Otitis media: Rapid evidence review, American Family Physician
Swimmer’s ear (otitis externa), Nemours Kids Health
Inner ear infection (otitis interna), Cleveland Clinic
After receiving her doctorate from the University of Pittsburgh School of Pharmacy, Karen Berger, Pharm.D., has worked in both chain and independent community pharmacies. She currently works at an independent pharmacy in New Jersey. Dr. Berger enjoys helping patients understand medical conditions and medications—both in person as a pharmacist, and online as a medical writer and reviewer.
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