Middle Ear Infection

Reviewed on 10/6/2021

What Is a Middle Ear Infection?

Picture of the outer and inner structures of the ear
Picture of the outer and inner structures of the ear
  • Infection can affect the ear canal (otitis externa), the eardrum (myringitis), or the middle ear (otitis media).
  • Most ear injuries are caused by pressure changes during a direct injury (such as a blow to the ear) or sports scuba diving, but, a persistently painful ear may signal an infection that requires treatment.
  • Because an ear scope (otoscope) may not be available to examine the canal and inner ear in remote locations, starting therapy may be appropriate until a doctor can be reached.

What Are the Signs and Symptoms of a Middle Ear Infection?

Symptoms and signs of an ear infection include:

Symptoms may follow a respiratory infection such as the common cold.

Discharge from the ear canal is often caused by the infection known as swimmer's ear (otitis externa). A painful ear with decreased hearing is often the result of otitis media, a middle ear infection.

What Is the Treatment for a Middle Ear Infection?

  • Pain may be relieved with 1 to 2 acetaminophen (Tylenol) every four hours and/or 1 to 2 ibuprofen (Advil, Motrin) every 6 to 8 hours.
  • Pseudoephedrine (the active ingredient in over-the-counter medications such as Sudafed) 30 mg tablets, one every six hours for 2 to 3 days, may ease ear pressure. (People with a history of high blood pressure should avoid this product.)
  • For infections of the ear canal (otitis externa): neomycin (Ak-Spore HC, Cortisporin, Neotricin HC, Ocutricin-HC), polymyxin B, and hydrocortisone (Cortisporin, Otocort, Poly Otic), two drops in the ear canal four times per day for five days, may also be used.
  • Fluoroquinolone antibiotics specifically for the ear are also available (ofloxacin, and ciprofloxacin with dexamethasone) to treat otitis externa and otitis media with a perforation or in the presence of ear tubes.
  • If pain occurs, discontinue treatment and seek medical attention.
  • Oral antibiotics are usually recommended for discharge from the ear, nose, or mouth. If an infection develops, continue antibiotics for at least five days after all signs of infection have cleared. Tell your doctor of any drug allergy prior to starting any antibiotic. The doctor will recommend the right antibiotic. Some can cause sensitivity to the sun, so use sunscreen (at least SPF 15). Some patients may be sensitive to topical neomycin and have further irritation.

When to Call a Doctor for a Middle Ear Infection

  • Seek medical treatment as soon as possible for an examination of the ear if an ear infection is suspected.
  • Seek medical treatment immediately if you experience a sudden loss in hearing in one or both ears (usually occurring over a period of less than 24-48 hours).
  • Elderly people and people with high blood pressure should use decongestants with caution.
  • Consult a doctor about treatment with available medications for an ear infection.
Reviewed on 10/6/2021
Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics


"Acute otitis media in adults (suppurative and serous)." UptoDate.com.