Medicines and treatments for a middle ear infection

A middle ear infection (otitis media) will often get better by itself in a few days as the body’s immune system can take care of the infection without any treatment.

Children with a middle ear infection

Most children older than 2 years won’t need antibiotics to treat a middle ear infection — the infection will clear up by itself in a few days. However, many children younger than 2 years may need antibiotics to treat the infection.

Antibiotics won’t help relieve your child’s ear pain. Whilst a child’s ear pain will be of concern to their parents or carers, studies show that 6 out of 10 children will have no ear pain after the first 24 hours without any treatment (antibiotics or pain relief).

Pain relief medicines (such as paracetamol or ibuprofen) can help to relieve the symptoms of an ear infection, and will usually only be needed for a short time.

Find out more about paracetamol and ibuprofen and how to relieve the symptoms of a middle ear infection.

If your child’s symptoms don’t improve after a few days, or their symptoms get worse, see your doctor.

Antibiotics for middle ear infections in children

Antibiotics are recommended for children with middle ear infections who:
  • are younger than 6 months
  • are younger than 2 years old with an infection in both ears or fluid leaking out of their ear (called ‘otorrhoea’)
  • have a fever (a temperature of 38.5°C or higher) and are vomiting
  • are from Aboriginal and Torres Strait Islander communities.

Find out more about how to treat a fever.

Babies and infants younger than 6 months old

Infants younger than 6 months old who have ear infections (with or without fever or vomiting) will usually be prescribed an antibiotic. Your doctor will usually ask to see your baby again in 24 hours.

Children aged 6 months to 2 years

Your doctor will advise you on how to relieve the symptoms of a middle ear infection. Your doctor may ask to see your child after 24 hours, or contact you to ask how they are. If your child’s symptoms don’t improve after 24 hours, your doctor may prescribe antibiotics.

Children aged 2 years or older

Your doctor will advise you on how to relieve the symptoms of a middle ear infection. If your child’s symptoms don’t improve in 2 days, your doctor will usually examine your child again and may prescribe antibiotics if necessary.

Aboriginal and Torres Strait Islander children

Chronic (long-term) middle ear infections are very common in Aboriginal and Torres Strait Islander children, and even though the infection can be treated, it is the most common cause of hearing loss in these children. Antibiotics will usually be prescribed for children in Aboriginal and Torres Strait Islander communities because they have a higher risk of hearing loss from ongoing middle ear infections.

Which antibiotics are used to treat a middle ear infection?

If an antibiotic is necessary, amoxycillin is recommended. If your child is allergic to penicillin, your doctor may prescribe a different antibiotic (cefuroxime, or cefaclor). If the infection does not improve with amoxycillin, then amoxycillin with clavulanic acid will usually be given.

To find out more, read our medicines information on amoxycillin, cefuroxime, cefaclor, and amoxycillin with clavulanic acid.

Note about medicines names

Most medicines have two names: the active ingredient and the brand name. The active ingredient is the chemical in the medicine that makes it work. The brand name is the name given to the medicine by its manufacturer. There may be several brands that contain the same active ingredient. This website uses active ingredient names (e.g. amoxycillin), with brand names in brackets and with a capital letter (e.g. Amoxil). We also discuss medicines in groups or ‘classes’ when their effects or actions are very similar.

To find out more about active ingredients and brand names read our brand choices information.

Tell your doctor about all the medicines you are taking

It is important that you tell your health professional about all the medicines you or anyone in your care is taking — including prescription, over-the-counter and complementary medicines (herbal, ’natural’, and vitamin or mineral supplements). This is because all medicines, including herbal and natural medicines, can cause side effects and may interact with other medicines.

Adults with a middle ear infection

Most adults won’t need antibiotics to treat a middle ear infection — the infection will clear up by itself in a few days.

Your doctor can provide advice about how to relieve your symptoms. If your symptoms don’t improve in 2 days, your doctor will usually examine you again and may prescribe antibiotics.

  • Paracetamol, ibuprofen or aspirin can help relieve the pain caused by an ear infection. For more information, read about paracetamol, ibuprofen and aspirin.
  • If an antibiotic is necessary to treat your ear infection, amoxycillin is recommended. If you are allergic to penicillin you can’t take amoxycillin, so your doctor may prescribe a different antibiotic (cefuroxime or cefaclor).
  • If the infection does not improve with amoxycillin, then amoxycillin with clavulanic acid is recommended.

Find out how to relieve the symptoms of an ear infection.

Read about amoxycillin, cefuroxime, cefaclor, and amoxycillin with clavulanic acid.

Phone for medicines information

Call NPS Medicines Line on 1300 MEDICINE (1300 633 424) to get information about your prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and mineral supplements) from a pharmacist. Your call will be answered by healthdirect Australia.

References
  • Sanders S, Glasziou PP, Del Mar CB, Rovers MM. Antibiotics for acute otitis media in children. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD000219. DOI: 10.1002/14651858.CD000219.pub2.
  • Respiratory Expert Group. Therapeutic guidelines. Respiratory: Otitis media. Melbourne: Therapeutic Guidelines Ltd; 2012. (Accessed 26 March 2012).
  • Darwin Otitis Guidelines Group. Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations. Canberra: Australian Government Department of Health and Ageing, April 2010.
    www.health.gov.au/internet/main/publishing.nsf/Content/health-oatsih-pubs-omp.htm
    (accessed 26 March 2012).
  • Rossi S, ed. eAMH [online]. Adelaide: Australian Medicines Handbook, July 2012.