Ear infections

An ear infection, medically known as otitis media (OM), occurs when the middle ear, the space behind the eardrum where the tiny bones of the ear transmit sound vibrations, becomes inflamed. This inflammation is usually due to bacterial or viral causes. As a result of the infection, fluid accumulates behind the eardrum, leading to symptoms such as ear pain and hearing difficulties.

Kids get ear infections more often

Ear infections are more frequent in children than in adults. In fact, they are the primary reason why parents take their children to see a primary care provider. While ear infections can affect individuals of any age, they are particularly common among young children.

Even for mild ear infections, get a treatment plan

There are three distinct types of ear infections, and none of them are contagious.

Thankfully, many ear infections resolve on their own. However, your primary care provider may initiate a treatment plan for you or your child, focusing on pain management and closely monitoring the issue.

Causes and types of ear infections

A middle ear infection typically stems from bacteria like Streptococcus pneumoniae or Haemophilus influenzae, or viruses akin to those causing common colds or the flu. These conditions can lead to congestion and swelling in the nasal passages, throat, ear canal, and eustachian tubes.

As per the Centers for Disease Control and Prevention (CDC), this manifests in three primary types of ear infections:

  • Acute otitis media (AOM): This prevalent type involves inflammation and infection of the middle ear, with fluid trapped behind the eardrum.

  • Otitis media with effusion (OME): Occurs when fluid builds up in the middle ear without being infected and without causing fever, ear pain or pus build-up. A child with OME may have no symptoms, but your provider will be able to see the fluid behind the eardrum with a special instrument.

  • Chronic otitis media with effusion (COME): A subtype characterized by prolonged or recurrent fluid retention in the middle ear, even in the absence of infection. COME compromises children's ability to combat new infections and can impact their hearing.

  • Otitis externa, (“swimmer’s ear”):  This type arises from infection in the outer ear canal, distinct from a middle ear infection.

The impact of secondhand smoke: The Centers for Disease Control and Prevention (CDC) identifies secondhand smoke as a confirmed risk factor for increasing the occurrence of ear infections in infants and children, along with other health issues. If you are seeking assistance in quitting smoking, your primary care provider is available to offer support.


Recognizing Ear Infection Symptoms

(and when to see your primary care provider for your child)


Common indicators for adults include:

  • Ear pain

  • Fluid drainage from the ear

  • Difficulty hearing

If your symptoms persist, worsen, or if you develop a fever, it's important to schedule an appointment with your primary care provider.

Moreover, if you have a history of recurrent ear infections, seeking medical attention is crucial to prevent potential hearing impairment and other severe complications.

Your child

For children, ear infections are much more common—according to the National Institute of Health, ear infections are the most common reason parents bring their child to a primary care provider.

Typical symptoms in children encompass:

  • Excessive crying

  • Fluid drainage from the ear

  • Ear pain, particularly when lying down

  • Irritability

  • Headaches

  • Reduced appetite

  • Impaired balance

  • Difficulty hearing or responding to sounds

  • Disrupted sleep patterns

  • Tugging or pulling at the ear

When to see your provider

It's crucial to promptly contact your primary care provider if your child experiences:

  • A fever reaching 102.2°F (39°C) or higher

  • Noticeable hearing impairment

  • Discharge of pus, fluid, or blood from the ear

  • Persistence of middle ear infection symptoms beyond 2–3 days

  • Deterioration of symptoms

For very young children

If your child is under 3 months old, seek immediate medical assistance if they exhibit:

  • A fever of 100.4°F (38°C) or above

  • Restlessness or irritability accompanying a cold or upper respiratory infection

  • Discharge of pus, fluid, or blood from the ear

  • Showing signs of severe ear pain

Ear infection treatment


Adults can try these methods to feel better at home while a common middle ear infection runs its course:

  • Anesthetic ear drops may provide pain relief, provided there is no perforation or tear in the eardrum

  • Ensure adequate hydration by consuming additional water or other fluids

  • Prioritize rest

  • Utilize over-the-counter pain relievers such as acetaminophen or ibuprofen

These home remedies may also be suitable for your child, incorporated into a treatment regimen developed by your primary care provider, tailored to the type of ear infection and specific symptoms observed.


For a mild case of middle ear infection, this plan might start with:

A wait-and-see approach. Typically, symptoms of ear infections exhibit improvement within the initial days, with many infections resolving spontaneously within one to two weeks sans any intervention.

Both the American Academy of Pediatrics and the American Academy of Family Physicians propose an observational approach as a viable strategy for:

  • Children aged 6 to 23 months experiencing mild middle ear discomfort in one ear for under 48 hours, coupled with a temperature below 102.2 F° (39° C).

  • Children aged 24 months and above with mild middle ear discomfort in one or both ears for less than 48 hours, alongside a temperature below 102.2° F (39° C).

Delayed prescribing. Your child’s doctor may prescribe an antibiotic such as amoxicillin, but suggests that you wait two to three days to see if your child is still sick before filling it.

After the wait-and-see period

Following the observation period, your healthcare provider may prescribe antibiotics for your child according to these criteria:

  • Children aged 6 months and older experiencing moderate to severe ear pain in one or both ears for at least 48 hours or with a temperature of 102.2°F (39°C) or higher

  • Children aged 6–23 months with mild middle ear pain in one or both ears for less than 48 hours and a temperature below 102.2°F (39°C)

  • Children aged 24 months and older with mild middle ear pain in one or both ears for less than 48 hours and a temperature below 102.2°F (39°C)


Even if symptoms improve, it's crucial to follow the antibiotic regimen as prescribed. Incomplete medication courses can result in recurrent infection and bacterial resistance to antibiotics. Consult your healthcare provider or pharmacist for guidance if you miss a dose unintentionally.