How is a middle ear infection treated?

Treatment generally involves an individualized, multifaceted plan that addresses the infection, minimizes ear pain, and reduces the possibility of complications, such as hearing loss. There is great controversy surrounding the use of antibiotics in young children since outcomes are not better than supportive treatments. Many worry about overprescribing of antibiotics, which can lead to the development of antibiotic-resistant organisms.

Treatment of a middle ear infection may include:

  • Acetaminophen (Tylenol) for fever and ear pain

  • Antibiotic medications for ear infections caused by bacteria. Antibiotics may be given as oral pills or in ear-drop form. Antibiotics are ineffective against viruses and are not prescribed for middle ear infections caused by a virus.

  • Corticosteroids to reduce ear inflammation and pain

  • Drinking extra fluids

  • Follow-up medical care, as recommended, during and after a middle ear infection to reevaluate the ear and assess the risk of developing complications, such as hearing loss and chronic otitis media

  • Getting extra rest and sleep

  • Surgery in some cases to insert tubes in the ears to drain excess ear fluid, remove infected tissue, or repair a damaged eardrum. Tonsillectomy may be recommended for recurrent otitis media caused by Eustachian tube obstruction due to swollen tonsils.

If you or your child has a middle ear infection, do not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called Reye syndrome. Reye syndrome has been linked to taking aspirin during a viral illness, such as a viral middle ear infection or flu.

What are the possible complications of a middle ear infection?

Complications of a middle ear infection can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of a middle ear infection include:

  • Bell’s palsy (swollen or inflamed nerve that controls facial muscles)

  • Brain abscess

  • Chronic otitis media (ongoing middle ear infection)

  • Enlarged adenoids (enlarged lymphoid tissue in the back of the nose)

  • Loss of hearing, even deafness

  • Meningitis (infection or inflammation of the sac around the brain and spinal cord)

  • Ruptured eardrum


  1. Ear infections in children. National Institute on Deafness and Other Communication Disorders.
  2. Middle ear infections. KidsHealth, a service of Nemours.
  3. Ear infections.
  4. Torpy, JM, Lynm, C, Glass, RM. Acute otitis media. JAMA Patient Page. JAMA. 2010;304(19):2194.
  5. Feigin RD, Cherry JD, Demmler-Harrison GJ, Kaplan SL (Eds), Textbook of Pediatric Infectious Diseases, 6th ed. Philadelphia: Saunders, 2009.
  6. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.

What is a middle ear infection?

A middle ear infection, also called otitis media, is a common, often painful, type of ear infection that occurs behind the eardrum. Middle ear infections are caused by bacteria or viruses. A middle ear infection can interfere with the normal process of hearing and result in ear pain, hearing impairment, and other symptoms. People of all ages can get a middle ear infection, but it is more common... Read more about middle ear infectionintroduction


What are the symptoms of a middle ear infection?

Symptoms of a middle ear infection can vary and differ depending on the specific type of infection. Young children are unable to clearly communicate symptoms. They may resort to crying and ear tugging.

Common symptoms of a middle ear infection include:


What causes a middle ear infection?

Normally, fluid in the middle ear drains through the Eustachian tube to the throat. When the Eustachian tube becomes blocked or swollen, the fluid builds up in the middle ear. Bacteria and viruses grow and multiply easily when fluid in the middle ear does not drain normally. Conditions that cause swelling or blockage of the Eustachian tube include:

Medical Reviewer: William C. Lloyd III, MD, FACS Last Annual Review Date: Sep 6, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

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