Do You Really Need Antibiotics for an Ear Infection?

Do you need antibiotics for an ear infection?. Sharon Dominick/E+/Getty Images

Ear infections are one of the most common reasons that antibiotics are prescribed - especially for children. Although ear infections occur more frequently in kids, adults get them too and they are painful.

There is mounting evidence that a majority of ear infections resolve on their own without treatment. That means most people that get ear infections shouldn't be taking antibiotics as soon as the pain starts.

While there are still some instances when antibiotics are warranted, most of the time a wait and see approach is better. 

Who Should Take Antibiotics

Some people who get ear infections should take antibiotics.  The American Academy of Pediatrics (AAP) recommends the following children be treated with antibiotics:

  • Children 6 months and younger diagnosed with acute otitis media (middle ear infection)
  • Children 6 months to 2 years with definite middle ear infections and severe symptoms - okay to wait if symptoms are not severe
  • Children 2 to 12 years with diagnosed middle ear infections and severe symptoms
  • Children with anatomical abnormalities or underlying conditions such as cleft palate, Down syndrome or other genetic conditions, immune system disorders, and cochlear implants
  • Children whose symptoms do not improve after 48-72 hours
  • Children who have a recurrence of an ear infection within 30 days of the last one

    What's Wrong With Taking Antibiotics?

    Up until recently, the thought was that taking antibiotics may not help, but they wouldn't hurt. Now we know that couldn't be more wrong. The rise in antibiotic resistant bacteria has been called one of the world's greatest public health threats. The more we take antibiotics when they aren't necessary, the more likely bacteria that are always present in our bodies are to develop the ability to resist those drugs.

    Once these drug resistant bacteria take hold, they require stronger antibiotics to kill them. These are more costly, have more serious side effects and often take longer to treat. In some cases, the antibiotic resistant infections can't be treated because the antibiotics we have don't work on them. It's a bad scenario that poses a serious threat to every one of us. 

    Reducing the amount of antibiotics that are prescribed when they aren't needed will help slow the progression of antibiotic resistant bacteria. 

    What Else Can You Do For An Ear Infection?

    If you or your child has an ear infection but you haven't been prescribed antibiotics, there are things you can do to get relief while you wait for it to clear up. 

    • Take pain relievers - for children, this means acetaminophen (Tylenol) or ibuprofen (Motrin or Advil)
    • Warm compresses on the ear
    • Pain relieving ear drops (if the eardrum isn't ruptured)

    If the pain is severe and is not relieved by over the counter medication, contact your health care provider for further guidance. 


    "Ear Infections in Children". Hearing, Ear Infections and Deafness March 2013. National Institute on Deafness and Other Communication Disorders. US Department of Health and Human Services. National Institutes of Health. 31 Jul 15. 

    "Middle Ear Infections". Bacterial and Viral Infections Oct 14. KidsHealth. The Nemours Foundation. 31 Jul 15. 

    "Antibiotic Resistance Questions and Answers". Get Smart: Know When Antibiotics Work 17 Apr 15. US Centers for Disease Control and Prevention. US Department of Health and Human Services. National Institutes of Health. 30 Jul 15. 

    "Middle Ear Infections". Ear Nose & Throat 5 May 15. American Academy of Pediatrics. 31 Jul 15. 

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