Medications

Antibiotics can treat ear infections. But most children with ear infections get better without them. If the care you give at home relieves pain, and a child's symptoms are getting better after a few days, you may not need antibiotics.

If your child has an ear infection and appears very ill, is younger than 2, or is at risk for complications from the infection, your doctor will likely give antibiotics right away. For children ages 2 and older, many doctors wait for a few days to see if the ear infection will get better on its own. When doctors do prescribe antibiotics, they most often use amoxicillin because it works well and costs less than other brands.

Ear Infection: Should I Give My Child Antibiotics?

Experts suggest a hearing test if a child has had fluid behind his or her eardrum longer than 3 months. Normal hearing is critical during the first 2 years when your child is learning to talk. Your doctor may prescribe antibiotics to help clear the fluid. But that usually doesn't help. The doctor may also suggest placing tubes in the ears to drain fluid and improve hearing.

Ear Problems: Should My Child Be Treated for Fluid Buildup in the Middle Ear?

Other medicines that can treat symptoms of ear infection include:

• Acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory medicines (for example, Advil, Motrin, and Aleve), for pain and fever. Follow all instructions on the label. If you give medicine to your baby, follow your doctor's advice about what amount to give. Do not give aspirin to anyone younger than 20 because of its link to Reye syndrome, a serious illness.
• Pain medicines such as codeine and some eardrops, which help with severe earache. But do not use eardrops if the eardrum is ruptured. For more information, see the safest way to insert eardrops.
• Sometimes corticosteroids, known as steroids, are given with antibiotics to get rid of fluid behind the eardrum (otitis media with effusion). Steroids are not a good choice for treating ear infections. Do not use steroids if a child has been around someone with chickenpox within the last 3 weeks.

Decongestants, antihistamines, expectorants, and other over-the-counter cold remedies usually do not work well for treating or preventing ear infections. Antihistamines that may make your child sleepy can thicken fluids and may actually make your child feel worse. Check with the doctor before giving these medicines to your child. Experts say not to give decongestants to children younger than 2.

Medication choices

Antibiotics may help cure ear infections caused by bacteria.

What to think about

Some doctors prefer to treat all ear infections with antibiotics. Some things to consider before your child takes antibiotics include:

• Risk for antibiotic-resistant bacteria. The greatest problem with using antibiotics to treat ear infections is the possibility of creating bacteria that can't be killed by the usual antibiotics (antibiotic-resistant bacteria). Using antibiotics only when they're needed can slow down this process.
• Side effects of antibiotics. Mild side effects, such as diarrhea and rash, from taking antibiotics are common. Severe side effects are rare.
• Cost. Most antibiotics are expensive. You may want to weigh the cost against the fact that most ear infections clear up without treatment.

If your child still has symptoms (fever and earache) longer than 48 hours after starting an antibiotic, a different antibiotic may work better. Call your doctor if your child isn't feeling better after 2 days of antibiotic treatment.