Middle Ear Infections - What Is Otitis Media?

Otitis media is an ear infection of the middle ear. It is most common in babies and young children, but can occur in adults as well. Otitis media can be caused by viruses or bacteria, and treatment is different based on age, symptoms and other factors. Middle ear infections often occur after an upper respiratory infection such as a cold or the flu.


Symptoms will vary based on age. In adults, persistent pain in the ear usually indicates an ear infection.

In younger children, the signs may not be as obvious because they are not able to tell you how they are feeling. Symptoms of ear infections in babies and young children may include:

  • Unusual fussiness or irritability
  • Fever
  • Pulling on the ear(s)
  • Difficulty sleeping
  • Fluid draining from ears
  • Signs of difficulty hearing – such as sitting closer to the television or not responding to soft sounds
  • Loss of balance
  • Nausea and vomiting

Diagnosing Otitis Media:

Because signs of middle ear infection vary, and any of these symptoms could be attributed to other illnesses or problems, the only definitive way to diagnose otitis media is an exam by your healthcare provider. He or she will use an otoscope to look in the ear to see if there is any inflammation or fluid in the middle ear. Most healthcare providers will not prescribe medication for ear infections over the phone.


Children get ear infections more frequently than any other age group and they typically occur during the first two to four years of life.

This is due to several factors. Young children have short Eustachian tubes (part of the ear anatomy that connects the middle ear to the back of the throat), which can allow bacteria and viruses to find their way in easily and cause infections. Children may also have large adenoids, which can interfere with the opening of the Eustachian tube, meaning that fluid has more difficulty draining.

Who Is Most Affected:

Children who are exposed to cigarette smoke, those that are bottle fed and those who attend daycare have higher rates of ear infections.

Otitis media also occurs more often in boys, in children who have a family history of frequent ear infections and in the winter, when colds and other respiratory illnesses are more common.

Treatment Options:

Treatment of middle ear infection depends on a variety of factors. Although treatment with antibiotics used to be standard for all ear infections, recent research has shown that many ear infections will clear up on their own within 3 to 5 days without treatment. If the ear infection is caused by a virus, an antibiotic will not help. When deciding if you or your child needs antibiotics, your healthcare provider may consider:

  • Age
  • The type and severity of the infection
  • The frequency of ear infections
  • The duration of the symptoms
  • Whether the hearing is affected
  • Other risk factors

Home Care:

You may also want to use over-the-counter medications, such as acetaminophen or ibuprofen, to help manage the pain.

Even if you or your child is treated with antibiotics, they will not help the pain, so these medications may be helpful. However, treatment with decongestants and antihistamines has not shown to be useful for ear infections and should not be used in children under 4 years old.


Learn about other types of ear infections.


”Otitis Media (Ear Infections).” National Institute on Deafness and Other Communication Disorders July 02. National Institutes of Health. 05 Feb 09.

”Middle Ear Infections.” KidsHealth June 08. Nemours Foundation. 05 Feb 09.

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