Ear Infection Basics

Overview

Children are more likely than adults to get ear infections. There are different types of ear infections.

• Middle ear infection (acute otitis media) is an infection in the middle ear.
• Otitis media with effusion is another condition that affects the middle ear.
  • Occurs when fluid builds up in the middle ear without causing an infection.
  • Does not cause fever, ear pain, or pus build-up in the middle ear.
• Swimmer's ear is an infection in the outer ear canal.
  • Different from a middle ear infection.
  • For more information, visit "Swimmer's Ear" (Otitis Externa)

Signs and symptoms

• Ear pain
• Fever
• Fussiness or irritability
• Rubbing or tugging at an ear
• Difficulty sleeping

Causes

• Bacteria, like Streptococcus pneumoniae and Haemophilus influenzae (nontypeable), are the two most common bacteria causing middle ear infection.
• Viruses, like those that cause colds can cause middle ear infection.

Prevention

Help prevent ear infections by doing your best to stay healthy and keep others healthy:

• Receive recommended vaccines, such as flu vaccine and pneumococcal vaccine.
  • Pneumococcal vaccine protects against a common cause of middle ear infections, Streptococcus pneumonia.

• Clean your hands.
• Breastfeed exclusively until your baby is 6 months old and continue to breastfeed for at least 12 months.
• Don't smoke and avoid exposure to secondhand smoke.
• Dry your ears thoroughly after swimming.

When to seek medical care

• A fever of 102.2°F (39°C) or higher.
• Pus, discharge, or fluid coming from the ear.
• Worsening symptoms.
• Symptoms of a middle ear infection that last for more than 2–3 days.
• Hearing loss.

This list is not all-inclusive. Please see a healthcare provider for any symptom that is severe or concerning.

Diagnosis

A healthcare provider can diagnose a middle ear infection by asking about symptoms and examining your child. They will look inside your child's ear to examine the eardrum and look for pus in the middle ear.

Treatment

• Talk to your child's healthcare provider about the best treatment. The body's immune system can often fight off middle ear infection on its own.
  • Sometimes you do not need antibiotics for middle ear infections.
  • Severe middle ear infections or infections that last longer than 2–3 days need antibiotics right away.

• For mild middle ear infection, your healthcare provider might recommend watchful waiting or delayed antibiotic prescribing.
  • Watchful waiting: Your child's healthcare provider may suggest watching and waiting for 2-3 days to see if your child needs antibiotics. This gives the immune system time to fight off the infection. If your child's symptoms don't improve, the healthcare provider may prescribe an antibiotic.
  • Delayed prescribing: Your child's healthcare provider may prescribe an antibiotic but suggest that you wait 2–3 days before filling the prescription. Your child may recover on their own and may not need the antibiotic.

How to feel better

• Rest.
• Drink extra water or other fluids.
• Take over-the-counter medicines to relieve pain or fever.

These actions can make you feel better, even if you use antibiotics.

Ask your healthcare provider about over-the-counter medicines that can help you feel better. Always use over-the-counter medicines as directed. Remember, over-the-counter medicines may provide temporary relief of symptoms, but they will not cure your illness.

Over-the-counter medicine and children

Carefully read and follow instructions on over-the-counter medicine product labels before giving medicines to children. Healthcare providers do not recommend some over-the-counter medicines for children of certain ages.

• Pain relievers:
  • Children younger than 6 months: only give acetaminophen.
  • Children 6 months or older: it is OK to give acetaminophen or ibuprofen.
  • Never give aspirin to children because it can cause Reye's syndrome. Reye's syndrome is a very serious, but rare illness that can harm the liver and brain.

• Cough and cold medicines:
  • Children younger than 4 years old: do not use over-the-counter cough and cold medicines in young children unless a healthcare provider specifically tells you to. Cough and cold medicines can result in serious and sometimes life-threatening side effects in young children.
  • Children 4 years or older: discuss with your child's healthcare provider if over-the-counter cough and cold medicines are safe to give to your child.

Ask your healthcare provider about the right dosage of over-the-counter medicines for your child's age and size. Also, tell your child's healthcare provider about all prescription and over-the-counter medicines they are taking.

Resources

For more on treatment of common illnesses, visit CDC resources:

• Acute Bronchitis
• Sinus Infection
• Sore Throat
• Urinary Tract Infection
• Common Cold Fact Sheet
• Skin Infection Fact Sheet

Print version: Preventing and Treating Ear Infections [PDF – 2 pages]