Sore Ear (Otitis media)

An ear infection is sometimes called ‘otitis media’. Symptoms of otitis media may include:

  • Earache – not all earaches are caused by an ear infection. If a child has earache but is otherwise well, an ear infection is unlikely.
  • Dulled Hearing.
  • Fever.
  • Children may feel sick or vomit, and can be generally unwell.
  • Young babies cannot point to their pain. One of the causes of a hot, irritable, crying baby is an ear infection.
  • Sometimes the eardrum perforates (bursts). This lets out infected mucus and the ear becomes runny for a few days. A burst eardrum often relieves the pain. A perforated eardrum usually heals within a few weeks after the infection clears.

Often during a cold, the middle ear space becomes filled with mucus (fluid). The mucus may then become infected by viruses or bacteria. Or, sometimes an ear infection occurs ‘out of the blue’ for no apparent reason.


Do I need an antibiotic?

Antibiotics are not advised in most cases. This is because in most cases the infection clears within 2-3 days on its own without treatment. In people who are normally well, your own immune system will usually clear the bacteria or viruses that cause ear infections. Antibiotics may cause side-effects such as thrush, diarrhoea, rash  and stomach upsets, so they  should not  be taken unnecessarily. Unnecessary use of some antibiotics has caused them to become less effective.

Antibiotics are more likely to be prescribed for an ear infection if:

  • Child is under two years old (as the risk of complications is greater in babies).
  • Infection is severe.
  • Infection is not settling within 2-3 days.
  • Complications develop.


Treatment options to relieve symptoms whilst waiting for your  immune system to clear the infection
Pain & fever relief Take paracetamol or ibuprofen regularly. Do not take any more than the recommended dose.


What are the possible complications from otitis media?

If a child is normally well, then the risk of other serious complications is small. It is common for some mucus to remain behind the eardrum after the infection clears. This may cause dulled hearing which usually clears within a week or so. Sometimes the mucus does not clear properly and ‘glue ear’ may develop. Hearing may then remain dulled. See a doctor if dulled hearing persists after an ear infection has gone.

If the eardrum perforates, then it usually heals over within a few weeks once the infection clears. In some cases the perforation remains long-term and may need treatment to fix it.

Rarely, a serious infection of the bone behind the ear develops from an ear infection. This is called mastoiditis and will require treatment with antibiotics.