What to Know About Antibiotics for Ear Infections - Verywell Health

An ear infection develops when bacteria or viruses infect the ear. There are three types: inner, middle, and outer ear infections. Many ear infections clear up on their own. However, if an ear infection doesn't get better after a few days, you will need to treat a bacterial ear infection with oral antibiotics and ear drops containing antibiotics.

Verywell / Katie Kerpel

Diagnosis of Ear Infections

Your physician will look into your ear with an otoscope, a medical instrument with a light on one end designed to get a better view inside the ear. Your doctor will look for the visual signs of ear infection, such as redness and inflammation.

To check for fluid buildup, a pneumatic otoscope, which blows air at the eardrum, will be used. If there is excessive fluid behind the eardrum, it will not move as it should when the air hits it.

In some cases, hearing tests may also be performed to assess any damage to the ear from the infection.

Different types of ear infections present with different symptoms, which can include:

• Inner ear infections: Hearing loss, ringing in the ears (tinnitus), dizziness, loss of balance, nausea and vomiting, and ear pain
• Middle ear infections: Fluid in the ear, ear pain, fever, a feeling of general illness, pressure in the ears, and hearing loss
• Outer ear infections: Inflammation of the ear canal, itching in the ear, ear pain, swelling of the ear canal, redness, and fluid draining from the ear

Ear Infection Doctor Discussion Guide

Children with ear infections, especially toddlers or infants, may not be able to describe their symptoms, but an ear infection will often present with the following signs:

• Tugging or pulling at their ears
• Fussing or crying
• Having difficulty sleeping
• Being clumsy and having balance issues
• Trouble hearing or responding to quiet noises

How Common Are Ear Infections in Children?

A majority of children will get an ear infection at some point during their childhood. Research has shown that roughly 90% of children will have at least one ear infection before they reach the age of 6.

Do You Need Antibiotics? 

Your physician may recommend a watch-and-see approach rather than prescribing antibiotics right away. Typically, you will keep an eye on symptoms for three days to see if they improve. This approach usually is used for children whose ear infections cannot be definitively diagnosed or who are under the age of 2.

If the infection does not clear up, you will need antibiotics. In some cases, a doctor will write you a prescription just in case the infection does not clear up.

If the ear infection is caused by a virus, antibiotics will not be prescribed because they do not work against viruses. Relieving symptoms while keeping an eye on the progression of the infection is the best course of treatment for a viral ear infection.

When to See a Doctor

Any signs of an ear infection should be addressed by your doctor. However, if you or your child is experiencing an ear infection that won't go away, continues to come back, or accompanies other symptoms, such as a fever, nausea, or vomiting, you should see your doctor right away.

Oral Antibiotics

In many cases, oral antibiotics come in liquid form for children and pill or capsule form for adults. First-line antibiotics are Amoxil (amoxicillin) and Penicillin VK (penicillin). If a person is allergic to penicillins, they will likely be treated with Omnicef (cefdinir), Ceftin (cefuroxime), or Biaxin (clarithromycin).

Certain strains of bacteria can develop antibiotic resistance, which means that the medication isn't as effective at killing off the infection. Your doctor will take this into account when choosing the right type of antibiotic for you or your child.  

How to Take Oral Antibiotics

It's important to always take your antibiotics as prescribed. It may be tempting to combine the doses, but they will not be as effective and could lead to adverse side effects, such as stomach upset.

Even if you begin to feel better, you should continue to take the antibiotics until you finish your medication to prevent the infection from returning. You should avoid alcohol while taking antibiotics.

While antibiotics are good for clearing a bacterial infection, they can also rid the body of helpful "good" bacteria at the same time. Because of this, you may want to consider taking a probiotic supplement while you are on antibiotics.

Probiotics are living organisms that can help to prevent the imbalance of bacteria within your gut that often comes from taking antibiotics. Studies have shown that taking probiotics while taking antibiotics can lower the chances of side effects from a bacterial imbalance, such as gastrointestinal upset and diarrhea.

Antibiotic Ear Drops

Antibiotics can also come in the form of ear drops. Since they do not go into the bloodstream, more medication reaches the infection in a shorter amount of time. Because of this, antibiotic ear drops can kill bacteria faster than oral antibiotics.

Antibiotic ear drops are typically used for outer ear infections and require a prescription from your physician. There are various types of medications that can be used to help treat an outer ear infection, including:

• Cipro (ciprofloxacin)
• Ocuflox (ofloxacin)

How to Use Ear Drops

Prior to using ear drops, you should always read the instructions provided to you with your prescription. You can also speak to your pharmacist or doctor for advice on using them. The following instructions will help you use ear drops correctly.

For adults:

• Lie down on a flat surface with a folded towel beneath your head and the affected ear facing the ceiling.
• Pull your earlobe up to straighten out the ear canal.
• Administer the appropriate number of drops into the ear.
• Push the ear flap gently to help ease the drops into the ear.
• Remain in this position for up to two minutes to ensure that the ear canal is fully coated with medicine.

For children:

• Have the child lie on the floor or bed with a towel beneath their head and their affected ear facing the ceiling.
• Hold their head still if they are squirming or fidgeting.
• Pull the earlobe out and down (instead of up as it is done with adults) to straighten their ear canal..
• Administer the recommended number of drops
• Press on their ear flap or place a cotton ball gently into the ear and let it remain in position for several minutes to ensure that the medication coats the inside of their ear.

The process for infants is similar to children, but you can also cradle your infant while you administer the drops in an appropriate position that allows the medication to go into their ear properly.

Who Shouldn't Use Ear Drops?

Ear drops can be helpful when treating an ear infection, but there are times when you shouldn't use them. For example, if you or your child has a perforated eardrum, you should avoid the use of certain ototoxic ear drops (those that have a toxic effect on the ear and the ear's nerve supply) because fluid from the drops can get deep into the ear and cause more problems.

Summary

Ear infections usually go away on their own, but if they don't, you may need antibiotics to treat them. Your doctor may prescribe an oral antibiotic or an antibiotic ear drop to treat your ear infection. It's important to complete the course of antibiotics prescribed to make sure your ear infection is treated completely and won't come back.

A Word From Verywell

Ear infections are incredibly common, and while you may want to get medication as soon as possible, it is not always needed. The best way to cope with an ear infection is to reduce symptoms using over-the-counter pain relievers and see a doctor for prescription medication only when you need it.

For recurring ear infections, further testing or medication may be required. If you or your child is suffering from recurring ear infections, taking antibiotics may not be the best route of treatment. However, speak with your doctor to find the most appropriate way to treat the infection.

Frequently Asked Questions

• If you have been prescribed antibiotics for an ear infection, the ear pain will likely clear up in two to three days. The hearing loss and fluid, however, may take up to several weeks to clear. Sometimes ear infections can last a lot longer even with antibiotic treatment. In some cases, if there is fluid in the middle ear, it can take up to six weeks for the infection to fully go away.

• Antibiotics for ear infections work the same way they do for other parts of the body. Some antibiotics seek out bacteria and attack the wall surrounding them. This leads to either death of the bacteria or their inability to reproduce. When bacteria are killed or fail to grow, the infection gets better and eventually clears up.

• If you take antibiotics for an ear infection but it doesn't go away, you likely have a chronic ear infection and will need to explore other forms of treatment with your physician. Your doctor may prescribe more antibiotics for a longer duration of time. The doctor may also change the way you take them, such as intravenously, directly into your bloodstream. There are other forms of treatment for chronic ear infections, such as surgery, depending on the type and symptoms that are associated with it.

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