Do ear infections always need to be treated with antibiotics?

I see many parents bring their children in to Express Care with ear infections and request antibiotics, but sometimes antibiotics aren’t the right choice. Most ear infections cure themselves without the help of antibiotics.

Let’s first discuss what an ear infection is and other approaches to take. An ear infection is a bacterial or viral infection that affects the ear. It becomes painful when buildups of fluid and inflammation occur in the air-filled space behind the eardrum. Signs and symptoms of infection will quickly show. A great way to tell if your child has an ear infection is if he or she start showing the following symptoms:

• Pain in the ear, especially while lying down
• Pulling or tugging the ear
• Difficulty sleeping
• Difficulty hearing or responding to sounds
• Fever or headache

Generally, an ear infection will improve within the first couple days, and clear up within one to two weeks without any treatment. It is recommended to use the wait-and-see approach for:

• Children age 6 to 23 months with mild inner ear pain in one ear for less than 48 hours and a temperature less than 102.2 F
• Children age 2 and older with mild inner ear pain in one or both ears for less than 48 hours and a temperature less than 102.2 F

There are other home remedies that can help manage your child’s pain. Try placing a warm, damp washcloth over the affected ear. Most providers recommend over-the-counter medication, such as ibuprofen or acetaminophen, to relieve pain. Use these medications as directed on the label.

Your medical provider can suggest the best treatment for your child. Antibiotics may be beneficial for certain children with ear infections. Your provider can explain the potential side effects and concerns about antibiotics creating strains of resistant disease. If antibiotics are prescribed, be sure to use the entire antibiotic as directed. Failing to do so can result in recurring infection and resistance of bacteria to antibiotic medication.

Check out these additional tips to reduce the risk of developing ear infections.

Leanna Munoz is a nurse practitioner at Express Care in Eau Claire, Wisconsin.