Do Middle Ear Infections Always Require Antibiotics?

July 15, 2023

Many times when children get an ear infection, watchful waiting is all that is needed. Ear infections usually go away on their own without the help of antibiotics.

When should I take my child to see a doctor if their ear hurts?

Guidance from the Centers for Disease Control and Prevention (CDC) is that observing the child is usually the best course of action, but it depends on their age, how high their temperature is, and if they have any other symptoms besides ear pain:

  • For children younger than 3 months old with a fever over 100.4°F: take them to a doctor right away
  • For children over 3 months old: take them to the doctor when their fever reaches 102.2°F, they have symptoms of an ear infection for more than 2-3 days, they have fluid coming out of the ear, or they have hearing loss

Why not just give them an antibiotic?

There are a few good reasons not to give a child antibiotics at the first sign of an ear infection:

  • Some ear infections are viral and cannot be treated with antibiotics.
  • When antibiotics are given too often, it causes bacteria to evolve and become less sensitive to antibiotics. This can lead to more serious infections.
  • There are side effects of antibiotic use, such as diaper rash, diarrhea, dizziness, abdominal pain, and nausea.

What can you give a child for fever and pain?

The following over-the-counter medications can be given to help keep the child comfortable:

  • Tylenol (acetaminophen) – if the child is younger than 6 months
  • Tylenol (acetaminophen)or Motrin/Advil (ibuprofen) – if the child is 6 months or older

Also make sure they are drinking plenty of fluids and resting.

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