Ear infection, inner - Treating middle ear infection

Most middle ear infections (otitis media) will clear up within three days and don't need any specific treatment.

You can relieve any pain and a high temperature using over the counter painkillers such as paracetamol and ibuprofen. However, aspirin should not be given to children under 16 years of age.

Placing a warm flannel or washcloth over the affected ear may also help relieve pain until the condition passes.

Antibiotics

The routine use of antibiotics to treat middle ear infections is not recommended as there is no evidence that they speed up the healing process. Many cases are caused by viruses, which antibiotics are ineffective against.

Using antibiotics to treat minor bacterial infections also increases the likelihood of bacteria becoming resistant to them over time. This means more serious infections could become untreatable in the future. Read about antibiotic resistance for more information.

Antibiotics are therefore usually only considered if:

your child has a serious health condition that makes them more vulnerable to complications, such as cystic fibrosis or congenital heart disease
your child is less than three months old, or they are less than two years old and have an infection in both ears
your child's symptoms are severe
your child has discharge coming from their ear
your child's symptoms show no signs of improvement after four days

If antibiotics are needed, a five-day course of an antibiotic called amoxicillin is usually prescribed. This is often given as a liquid suspension that your child has to drink. Common side effects of amoxicillin include a rash, feeling sick and diarrhoea.

If your child is allergic to amoxicillin, an alternative antibiotic such as erythromycin may be used.

In some cases, your GP may give you a prescription that you can choose to pick up a few days later if your child's condition hasn't improved by then.

Adults and children who develop a long-term middle ear infection (chronic suppurative otitis media) may benefit from short courses of antibiotic ear drops.

Grommets

For children with recurrent severe middle ear infections, tiny tubes may be inserted into the eardrum to help drain fluid. These tubes are called grommets.

Grommets are inserted under general anaesthetic, which means your child will be asleep and won't feel any pain. The procedure usually only takes about 15 minutes and your child should be able to go home the same day.

A grommet will help keep the eardrum open for several months. As the eardrum starts to heal, the grommet will slowly be pushed out of the eardrum and will eventually fall out. This process happens naturally and should not be painful. Most grommets will fall out within 6 to 12 months of being inserted.

Some children will need another procedure to replace the grommets if they are still experiencing problems.

Glossary

Chronic: Chronic usually means a condition that continues for a long time or keeps coming back.
Antibiotic: Antibiotics are medicines used to treat infections caused by micro-organisms, usually bacteria or fungi. For example amoxicillin, streptomycin and erythromycin.
Pain: Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign it has been damaged.
Fever: A high temperature, also known as a fever, is when someone's body temperature rises above the normal 37°C (98.6°F).
Antihistamines: Antihistamine medicine counteracts the action of histamine (a chemical released during an allergic reaction). For example loratadine, hydroxyzine.
Swelling: Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Acute: Acute means occurring suddenly or over a short period of time.
Decongestants: Decongestant medicine relieves congestion by reducing the swelling of the lining of the nose and sinuses and drying up the mucus.