Table of ContentsView AllTable of ContentsIs Treatment Needed?Home TreatmentAntibiotic TreatmentSevere InfectionsNext in Ear Infection GuideWhat Is an Ear Infection?
Table of ContentsView All
View All
Table of Contents
Is Treatment Needed?
Home Treatment
Antibiotic Treatment
Severe Infections
Next in Ear Infection Guide
Ear infection treatments can vary based onwhich part of the earis infected. This includes middle ear infections (otitis media), which causeinflammationin the air-filled space behind the eardrum, and outer ear infections (otitis externa), which cause inflammation in the external ear canal.
Althoughearacheis the primary symptom of both middle and outer ear infections, the underlying cause can differ. The treatment will depend largely on whether the cause is viral, bacterial, or fungal and may involve pain medications, antibiotics, eardrops, or watchful waiting. Some cases can be treated with home remedies, while severe cases may require ear tubes to help drain fluids.
This article describes the various treatments for ear infections, including what to expect and what can be done if the treatments fail to clear the symptoms.
Can You Heal an Ear Infection Without Treatment?
Middle ear infections often heal on their own without treatment. The same may be true for outer ear infections, but they generally take longer and are more likely to require treatment. The differences are due to how each type of infection develops.
Middle Ear Infections
Children are more often affected because theirimmune systemsare less developed. Their eustachian tubes are also smaller and more horizontal, making it harder to drain fluid from the ear. Because of this, they can have recurrent infections, sometimes as many as four or five per year.
URTIs associated with middle ear infections are typically viral. These include rhinoviruses (the most common cause of colds),influenza virus (the flu), andrespiratory syncytial virus (RSV). More often than not, the ear infection will clear once the viral URTI runs its course.
As a result, most middle ear infections don’t need specific treatment and will usually clear within three to five days.
What Causes Ear Infections?
Outer Ear Infections
Otitis externa can affect both children and adults. It is popularly known asswimmer’s earbecause water remaining in the ear after swimming creates the ideal environment for bacteria or fungi to grow. The infection can also occur when a foreign object such as a cotton swab or ear plug introduces bacteria into the ear canal.
Because the moisture in the ear canal encourages bacterial and fungal growth, it often takes a while for the immune system to control the infection.
Without treatment, it can take several weeks rather than days for an outer ear infection to clear.The problem with this is that, when left untreated, the persistent inflammation can cause permanent narrowing of the ear canal and hearing loss.
Getting Over an Ear Infection With Treatment at Home
Many middle and outer ear infections can be treated quickly and effectively at home. This includes home remedies and over-the-counter (OTC) medications used to relieve inflammation, pain, and swelling.
The at-home treatment of otitis media is mainly focused on pain relief. Given that most cases start as a URTI like a cold or flu, the treatment may include:
Aspirin Warning
In addition to OTC medications, rest and plenty of fluids can help resolve the underlying URTI.
Additional home remedies that can help include:
The treatment of swimmer’s ear primarily involves ear drops. Several OTC options either acidify the ear canal (making it hostile to bacteria or fungi) or dry the ear canal (removing the moisture that promotes bacterial or fungal growth).
Options include:
Ear drops are usually applied three or four times daily for five to seven days. Instructions vary, so speak with your pharmacist or healthcare provider to ensure you are using them correctly.
In addition to ear drops, OTC pain relievers like Tylenol, Advil, or Aleve can help ease ear pain.
How to Use Ear Drops Correctly
Getting Over an Ear Infection With Antibiotic Treatment
Oralantibioticsmay be prescribed for middle ear infections that do not resolve on their own. Antibiotic or antifungal ear drops may be used to treat outer ear infections, whilecorticosteroid(steroid) ear drops can help ease inflammation and pain.
According to guidelines from the American Academy of Pediatrics, a watchful-waiting approach is preferred in most children with acute otitis media. This is because four out of five children with otitis media will get better without antibiotics.
Antibiotics are typically reserved for:
In such cases, the recommended first-line treatment is high-doseAmoxil (amoxicillin)prescribed as follows:
Middle Ear Infections in AdultsMiddle ear infections in adults are less common but often more serious due in part to underlying risk factors (like smoking orcompromised immunity) that give rise to complications likemastoiditis(a type of skull bone infection) and permanent hearing loss.Because of this, otitis media in adults is more often treated with antibiotics than not. The recommended treatment isAugmentin (amoxicillin and clavulanate)taken every 12 hours for 10 days.
Middle Ear Infections in Adults
Middle ear infections in adults are less common but often more serious due in part to underlying risk factors (like smoking orcompromised immunity) that give rise to complications likemastoiditis(a type of skull bone infection) and permanent hearing loss.Because of this, otitis media in adults is more often treated with antibiotics than not. The recommended treatment isAugmentin (amoxicillin and clavulanate)taken every 12 hours for 10 days.
Middle ear infections in adults are less common but often more serious due in part to underlying risk factors (like smoking orcompromised immunity) that give rise to complications likemastoiditis(a type of skull bone infection) and permanent hearing loss.
Because of this, otitis media in adults is more often treated with antibiotics than not. The recommended treatment isAugmentin (amoxicillin and clavulanate)taken every 12 hours for 10 days.
Although otitis externa can often be treated with OTC ear drops, prescription ear drops may be needed for the infection. These are often prescribed for people who have swelling and obstruction of the ear canal.
Antibiotic ear drops used for otitis externa are sometimes combined with a corticosteroid likehydrocortisonethat helps ease inflammation. Options include:
In most cases, you will need to use the ear drops for 10 to 14 days.
If there is ear swelling that blocks the ear canal, your healthcare provider may need to insert a tiny sponge into your ear canal called a wick. Applying the drops to the wick allows the medicine to be drawn into the ear canal beyond any areas of inflammation. Ear wicks can be left in place for two to three days and replaced with fresh ones if needed.
When Not to Use Ear DropsYou should avoid using ear drops—particularly over-the-counter ear drops—if you think you have aruptured eardrum. Symptoms include sudden hearing loss, ear pain, ringing in the ears, ear drainage, andvertigo(spinning sensations).There are ear drops like Floxin Otic that can be prescribed if your eardrum is punctured, but these should only be used under the direction of a healthcare provider. Other ear drops can be toxic to the middle ear, injuring the hearing bones (ossicles) as well as the eustachian tube.
When Not to Use Ear Drops
You should avoid using ear drops—particularly over-the-counter ear drops—if you think you have aruptured eardrum. Symptoms include sudden hearing loss, ear pain, ringing in the ears, ear drainage, andvertigo(spinning sensations).There are ear drops like Floxin Otic that can be prescribed if your eardrum is punctured, but these should only be used under the direction of a healthcare provider. Other ear drops can be toxic to the middle ear, injuring the hearing bones (ossicles) as well as the eustachian tube.
You should avoid using ear drops—particularly over-the-counter ear drops—if you think you have aruptured eardrum. Symptoms include sudden hearing loss, ear pain, ringing in the ears, ear drainage, andvertigo(spinning sensations).
There are ear drops like Floxin Otic that can be prescribed if your eardrum is punctured, but these should only be used under the direction of a healthcare provider. Other ear drops can be toxic to the middle ear, injuring the hearing bones (ossicles) as well as the eustachian tube.
Ear Infection Treatment Not Working
In an ideal situation, an ear infection will clear on its own or with a short course of medications. But this is not always the case, and some acute infections can resist treatment and become chronic.
An ear infection is consideredacuteif it lasts for up to six weeks andchronicif it recurs three times or more in a six-month period or four times a year.
Depending on the symptoms, there are several ways a healthcare provider can deal with a chronic ear infection.
If a middle ear infection does not respond to treatment, atympanostomy tube(ear tube) may be needed to drain fluids and promote healing. These are typically used for people with recurrent middle ear infections or a long-lasting complication calledserous otitis mediain which fluid remains in the middle ear even after the infection has cleared.
Tympanostomy tubes improve hearing and also prevent recurrent infections and the overuse of antibiotics.
Tympanostomy tubes are placed underlocal anesthesiausing a thin scope (called atranscanal endoscope) that directs the placement of the 2-millimeter tube in the eardrum. Once inserted, the tube is left in place until it falls out on its own, usually within four to 18 months. The hole will usually close on its own.
Mastoiditis
Malignant Otitis Externa
Rarely, an outer ear infection can spread into the floor of the ear canal and the bones of the base of the skull. This happens most often in people with a weakened immune system, including those with diabetes or who are undergoing chemotherapy.
How to Prevent Ear Infections
Ways to reduce the risk of ear infections in you or your child include:
Summary
Outer ear infections (otitis externa), common in adults and children, are mainly treated with ear drops. These include over-the-counter ear drops that are mildly acidic or reduce moisture in the ear canal. Outer ear infections may require prescription ear drops containing an antibiotic, antifungal, or corticosteroid drug.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Klein JO. Klein JO.Otitis externa, otitis media, and mastoiditis.Mandell Douglas Bennett Principles Practice Infect Dis.2015;767–773.e1. doi:10.1016/B978-1-4557-4801-3.00062-XLieberthal AS, Carroll AE, Chonmaitree T, et al.The diagnosis and management of acute otitis media.Pediatrics. 2013;131(3):e964-e999. doi:10.1542/peds.2012-3488National Health Service (UK).Middle ear infection (otitis media).Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surgery. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surgery. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083National Health Service (UK).Outer ear infection (otitis externa).Wiegand S, Berner R, Schneider A, Lunderhausen, Dietz A.Otitis externa: investigation and evidence-based treatment.Dtsch Arztebl Int. 2019;11(13):224–234. doi:10.3238/arztebl.2019.0224Centers for Disease Control and Prevent.Ear infection.Head K, Chong LY, Bhutta MF, et al.Topical antiseptics for chronic suppurative otitis media.Cochrane Database Syst Rev.2018;2018(6):CD013055. doi:10.1002/14651858.CD013055American Academy of Family Physicians.Clinical guidelines; acute otitis externa.Taylor JA, Jacobs J.Homeopathic ear drops as an adjunct in reducing antibiotic usage in children with acute otitis media.Glob Pediatr Health. 2014;1:2333794X14559395. doi:10.1177/2333794X14559395American Academy of Pediatrics.Otitis media.Dundar R, Iynen I.Single dose topical application of clotrimazole for the treatment of otomycosis: is this enough?J Audiol Otol.2019;23(1):15–19. doi:10.7874/jao.2018.00276Jefferson ND, Hunter LL.Contemporary guidelines for tympanostomy tube placement.Curr Treat Options Peds.2016;2:224–235. doi:10.1007/s40746-016-0055-7MedlinePlus.Malignant otitis externa.Kaya İ, Sezgin B, Eraslan S, Öztürk K, Göde S, Bilgen C, Kirazlı T.Malignant otitis externa: a retrospective analysis and treatment outcomes.Turk Arch Otorhinolaryngol. 2018;56(2):106-110. doi:10.5152/tao.2018.3075
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Klein JO. Klein JO.Otitis externa, otitis media, and mastoiditis.Mandell Douglas Bennett Principles Practice Infect Dis.2015;767–773.e1. doi:10.1016/B978-1-4557-4801-3.00062-XLieberthal AS, Carroll AE, Chonmaitree T, et al.The diagnosis and management of acute otitis media.Pediatrics. 2013;131(3):e964-e999. doi:10.1542/peds.2012-3488National Health Service (UK).Middle ear infection (otitis media).Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surgery. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surgery. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083National Health Service (UK).Outer ear infection (otitis externa).Wiegand S, Berner R, Schneider A, Lunderhausen, Dietz A.Otitis externa: investigation and evidence-based treatment.Dtsch Arztebl Int. 2019;11(13):224–234. doi:10.3238/arztebl.2019.0224Centers for Disease Control and Prevent.Ear infection.Head K, Chong LY, Bhutta MF, et al.Topical antiseptics for chronic suppurative otitis media.Cochrane Database Syst Rev.2018;2018(6):CD013055. doi:10.1002/14651858.CD013055American Academy of Family Physicians.Clinical guidelines; acute otitis externa.Taylor JA, Jacobs J.Homeopathic ear drops as an adjunct in reducing antibiotic usage in children with acute otitis media.Glob Pediatr Health. 2014;1:2333794X14559395. doi:10.1177/2333794X14559395American Academy of Pediatrics.Otitis media.Dundar R, Iynen I.Single dose topical application of clotrimazole for the treatment of otomycosis: is this enough?J Audiol Otol.2019;23(1):15–19. doi:10.7874/jao.2018.00276Jefferson ND, Hunter LL.Contemporary guidelines for tympanostomy tube placement.Curr Treat Options Peds.2016;2:224–235. doi:10.1007/s40746-016-0055-7MedlinePlus.Malignant otitis externa.Kaya İ, Sezgin B, Eraslan S, Öztürk K, Göde S, Bilgen C, Kirazlı T.Malignant otitis externa: a retrospective analysis and treatment outcomes.Turk Arch Otorhinolaryngol. 2018;56(2):106-110. doi:10.5152/tao.2018.3075
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Klein JO. Klein JO.Otitis externa, otitis media, and mastoiditis.Mandell Douglas Bennett Principles Practice Infect Dis.2015;767–773.e1. doi:10.1016/B978-1-4557-4801-3.00062-XLieberthal AS, Carroll AE, Chonmaitree T, et al.The diagnosis and management of acute otitis media.Pediatrics. 2013;131(3):e964-e999. doi:10.1542/peds.2012-3488National Health Service (UK).Middle ear infection (otitis media).Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surgery. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surgery. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083National Health Service (UK).Outer ear infection (otitis externa).Wiegand S, Berner R, Schneider A, Lunderhausen, Dietz A.Otitis externa: investigation and evidence-based treatment.Dtsch Arztebl Int. 2019;11(13):224–234. doi:10.3238/arztebl.2019.0224Centers for Disease Control and Prevent.Ear infection.Head K, Chong LY, Bhutta MF, et al.Topical antiseptics for chronic suppurative otitis media.Cochrane Database Syst Rev.2018;2018(6):CD013055. doi:10.1002/14651858.CD013055American Academy of Family Physicians.Clinical guidelines; acute otitis externa.Taylor JA, Jacobs J.Homeopathic ear drops as an adjunct in reducing antibiotic usage in children with acute otitis media.Glob Pediatr Health. 2014;1:2333794X14559395. doi:10.1177/2333794X14559395American Academy of Pediatrics.Otitis media.Dundar R, Iynen I.Single dose topical application of clotrimazole for the treatment of otomycosis: is this enough?J Audiol Otol.2019;23(1):15–19. doi:10.7874/jao.2018.00276Jefferson ND, Hunter LL.Contemporary guidelines for tympanostomy tube placement.Curr Treat Options Peds.2016;2:224–235. doi:10.1007/s40746-016-0055-7MedlinePlus.Malignant otitis externa.Kaya İ, Sezgin B, Eraslan S, Öztürk K, Göde S, Bilgen C, Kirazlı T.Malignant otitis externa: a retrospective analysis and treatment outcomes.Turk Arch Otorhinolaryngol. 2018;56(2):106-110. doi:10.5152/tao.2018.3075
Klein JO. Klein JO.Otitis externa, otitis media, and mastoiditis.Mandell Douglas Bennett Principles Practice Infect Dis.2015;767–773.e1. doi:10.1016/B978-1-4557-4801-3.00062-X
Lieberthal AS, Carroll AE, Chonmaitree T, et al.The diagnosis and management of acute otitis media.Pediatrics. 2013;131(3):e964-e999. doi:10.1542/peds.2012-3488
National Health Service (UK).Middle ear infection (otitis media).
Rosenfeld RM, Schwartz SR, Cannon CR, et al.Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surgery. 2014;150(1_suppl):S1-S24. doi:10.1177/0194599813517083
National Health Service (UK).Outer ear infection (otitis externa).
Wiegand S, Berner R, Schneider A, Lunderhausen, Dietz A.Otitis externa: investigation and evidence-based treatment.Dtsch Arztebl Int. 2019;11(13):224–234. doi:10.3238/arztebl.2019.0224
Centers for Disease Control and Prevent.Ear infection.
Head K, Chong LY, Bhutta MF, et al.Topical antiseptics for chronic suppurative otitis media.Cochrane Database Syst Rev.2018;2018(6):CD013055. doi:10.1002/14651858.CD013055
American Academy of Family Physicians.Clinical guidelines; acute otitis externa.
Taylor JA, Jacobs J.Homeopathic ear drops as an adjunct in reducing antibiotic usage in children with acute otitis media.Glob Pediatr Health. 2014;1:2333794X14559395. doi:10.1177/2333794X14559395
American Academy of Pediatrics.Otitis media.
Dundar R, Iynen I.Single dose topical application of clotrimazole for the treatment of otomycosis: is this enough?J Audiol Otol.2019;23(1):15–19. doi:10.7874/jao.2018.00276
Jefferson ND, Hunter LL.Contemporary guidelines for tympanostomy tube placement.Curr Treat Options Peds.2016;2:224–235. doi:10.1007/s40746-016-0055-7
MedlinePlus.Malignant otitis externa.
Kaya İ, Sezgin B, Eraslan S, Öztürk K, Göde S, Bilgen C, Kirazlı T.Malignant otitis externa: a retrospective analysis and treatment outcomes.Turk Arch Otorhinolaryngol. 2018;56(2):106-110. doi:10.5152/tao.2018.3075
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