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Ear Infection

Español: Infección de oído

Preventing & Treating Ear Infections fact sheet [1 page]

Overview

Antibiotics are not recommended to help treat many ear infections. Your healthcare professional will be able to determine what kind of ear infection you or your child has and if antibiotics would help. Learn more below about two of the three main kinds of ear infections:otitis media with effusion and acute otitis media (AOM). Visit CDC's Healthy Swimming website to learn more about otitis externa (swimmer’s ear).

Causes

Otitis Media with Effusion

Otitis media with effusion, or OME, is a buildup of fluid in the middle ear without signs and symptoms of infection (pain, redness of the eardrum, pus, fever). The most common reasons for this fluid buildup include

Anatomy of the ear showing where fluid builds up in the middle ear and puts pressure, or pushes, on the ear. View larger image

When someone has an ear infection, fluid builds up in the middle ear.

  • Allergies
  • Irritants such as cigarette smoke
  • Previous respiratory infections—such as colds
  • Drinking while laying on your back
  • Changes in air pressure due to travel or elevation changes

OME almost always goes away on its own and will not benefit from antibiotics. After a respiratory infection, such as a cold or flu, has gone away, fluid may remain inside the ear and take a month or longer to go away. Sometimes this fluid can become infected, leading to acute otitis media (AOM). OME is more common than AOM.

Acute Otitis Media

Acute otitis media, or AOM, is the type of ear infection that affects the inside of the ear and can be painful. AOM is often caused by bacteria, but can also be caused by viruses. The bacteria that usually cause AOM are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The viruses that most commonly cause AOM are respiratory syncytial virus (RSV), rhinoviruses, influenza viruses, and adenoviruses.

Mild AOM, even if caused by bacteria, may get better without antibiotics. Watchful waiting without antibiotics for 2-3 days is a good treatment option for children with mild AOM. Children with mild AOM who are not better in 2-3 days also may need antibiotic treatment. Immediate antibiotic treatment is recommended for children with severe AOM. Your child’s healthcare professional can help determine if your child has mild or severe AOM, which depends on whether they have had a fever of 102.2°F (39°C) or higher, how long they have been sick, how severe their symptoms are, and, for children less than 2 years old, whether one or both ears are infected.

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Risk Factors

There are many things that can increase your risk for OME or AOM, including:

  • Age (children younger than 2 years are at higher risk)
  • Daycare attendance
  • Drinking from a bottle while laying down
  • Season (ear infections are more common during fall and winter)
  • Exposure to air pollution or secondhand smoke

Signs and Symptoms

Children with OME do not act sick and will not have any obvious symptoms, although temporary problems with hearing may be present. Symptoms more commonly associated with AOM include:

  • Ear pain
  • Pulling at ears
  • Excessive crying
  • Fluid draining from ears
  • Sleep disturbances
  • Fever
  • Headache
  • Problems with hearing
  • Irritability, especially with infants and toddlers

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When to Seek Medical Care

See a healthcare professional if you or your child has any of the following:

  • Temperature higher than 102.2 °F
  • Discharge of fluid, blood or pus from the ears
  • Symptoms that have  gotten worse
  • Symptoms that are not improving in 2-3 days after being diagnosed with an ear infection

If your child is younger than three months of age and has a fever, it’s important to always call your healthcare professional right away.

Diagnosis and Treatment

Ear infections can be diagnosed with a special instrument called an otoscope, which is used to look inside the ear at the eardrum. If OME is present, fluid may be visible, but there will be no signs of infection. If there are signs of infection, then AOM may be present.

Your healthcare professional will consider several factors when determining if antibiotics are needed for an ear infection: age, illness severity, options for follow-up, and if your child is less than 2 years old, whether one or both ears are infected. Since mild AOM will often get better on their own without antibiotic treatment, your healthcare professional may decide to wait a few days before prescribing antibiotics. OME almost always goes away on its own and will not benefit from antibiotics.

If your child’s symptoms continue to last for more than 2-3 days for AOM, contact your healthcare professional. If your child has symptoms of OME for more than one month or has hearing loss, contact your healthcare professional.

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Symptom Relief

Rest, over-the-counter medicines and other self-care methods may help you or your child feel better. For more information about symptomatic relief, visit the Symptom Relief section of this website or talk to your healthcare professional, including your pharmacist. Remember, always use over-the-counter products as directed. Many over-the-counter products are not recommended for children of certain ages.

Prevention

There are steps you can take to help prevent getting an ear infection, including:

  • Avoid smoking and exposure to secondhand smoke
  • Keep you and your child up to date with recommended immunizations
  • Breastfeed your baby for 12 months or more if possible
  • Bottle feed your baby in the upright position

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