What You Need to Know About Ear Infections

Symptoms, Diagnosis and Treatment of Ear Infections

ear exam
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One of the most common complications from a cold is an ear infection. They are much more common in young children, but can occur in adults as well. While most ear infections can be easily treated with or without antibiotics, recurrent infections can sometimes lead to hearing loss.


Most often, ear infections occur when fluid and pus build up in the middle ear. This type of infection is called otitis media.

A second type occurs when the outer ear gets infected. This is called otitis externa, but is better known as swimmer's ear.

Signs and Symptoms

For adults and older children, the most obvious sign that the ear may be infected is pain. Children often run a fever with ear infections, but not always. These symptoms usually appear after a person has had a cold or congestion.

Babies and young children experience pain, too, though they cannot tell their parents about their discomfort, and so other signs may be better clues. These include:

  • Pulling on the ear
  • Crying more than usual
  • Difficulty sleeping
  • Drainage from the ear
  • Problems with balance or hearing
  • Unexplained fever


Accurate diagnosis of an ear infection requires a visit to a healthcare provider. He or she will use a special instrument to look inside the ear to determine what type of ear infection you or your child has and what treatment is appropriate.


In years past, the routine treatment for ear infections was a round of antibiotics. However, in the past few years, there has been a sharp rise in antibiotic resistance. It is not a good idea to press a doctor for antibiotics over the phone without an examination because of this. In addition, several studies have also found that many ear infections will resolve on their own within 2 to 3 days without any type of treatment.

That is not to say that if you or your child gets an ear infection, you will not get antibiotics. It just means it is even more important to have your healthcare provider examine the ears and determine what course of treatment is right for you or your child.

According to the American Academy of Pediatrics, children younger than 6 months meet the criteria for antibiotics if their healthcare provider has examined them and can either see the infection or strongly suspects an infection because of the symptoms and course of illness. Children 6 months to 2 years require antibiotics if the diagnosis can be confirmed or they have severe symptoms that have been monitored and deemed to have worsened. If diagnosis cannot be confirmed, other treatment may be recommended. Antibiotics are recommended for children older than age 2 if diagnosis is confirmed and the child is very ill; antibiotics may be used in other cases if the child's symptoms become severe and worsen.

Treatment Reminders

If you do need antibiotics, it is important to remember that you will typically not see any difference in symptoms for at least 24 to 48 hours. This means there could still be a fever and significant ear pain during that time.

It doesn't mean the medication is not working, it simply has not had enough time to improve the symptoms yet.

It is also extremely important to take all of the prescribed medication. Not finishing prescribed antibiotics can also lead to more resistant bacteria. Even though you may feel better, that does not mean the infection is completely gone. Partially treating it enables it to become stronger and fight off medication.

Treating Children 

If a child wakes up during the night with ear pain, it is safe to wait until the morning for treatment as long as the pain is able to be controlled with acetaminophen or ibuprofen and there is no obvious deformity of the ear.

It is not a good idea to press a doctor for antibiotics over the phone without an examination because of the rise in antibiotic resistance.

If your child has chronic ear infections, it may also be necessary to have small tubes placed in his or her ears to help drain the fluid that is building up. Although this is a very common and fairly simple procedure, there are risks involved with any type of surgery or anesthesia and the decision should be one that is carefully evaluated by both the parents and physician.

The Bottom Line

If you suspect that you or your child may have an ear infection, it is important to see your healthcare provider. Chronic, recurrent ear infections in children can lead to hearing loss. However, an ear infection that comes on during the night is not necessarily an emergency, as long as the pain can be controlled. And if your doctor decides you don't need antibiotics, try the recommended approach for a few days. It could save you a lot of trouble in the future.


"Ear Infections." National Institute on Deafness and Other Communication Disorders 06 Dec 07. National Institutes of Health. Department of Health and Human Services. 06 Dec 07.

"Middle Ear Infections." Healthy Children.org 09 Mar 04. American Academy of Pediatrics. 01 Feb 12.