Antibiotics for middle ear infection

Examples

How It Works

Antibiotics kill bacteria.

Research shows that antibiotics often clear up middle ear infections (acute otitis media) caused by bacteria. Most children with ear infections take antibiotics for 5 days.¹ But if your child is younger than 2, he or she may need a longer course of antibiotics.

Most antibiotics are given in pill or liquid form. Sometimes the first dose of an antibiotic is given as a shot. Ceftriaxone is one example. It's often given just once, although in some situations a shot is given each day for 3 days in a row.

If ear infection persists, antibiotics may be given longer than the usual 5 to 10 days.

Why It Is Used

Antibiotics often clear up a bacterial ear infection. Amoxicillin is an antibiotic often chosen for treating ear infections. It works well and is less costly than other brands.

Doctors sometimes prescribe antibiotics to prevent infections in children who are prone to repeated ear infections (recurrent otitis media). But experts disagree on how helpful this is.

How Well It Works

Antibiotics are effective in most cases of ear infections caused by bacteria. However, only 1 out of 5 children with ear infections needs antibiotics to clear an ear infection. In 4 out of 5 children, ear infections clear on their own.² More health professionals are suggesting that parents wait a day or two before starting antibiotics. If the child starts to get better, no antibiotics are needed. If symptoms don't improve, then you can start giving the antibiotic.

Antibiotics will not be effective if the ear infection is caused by a virus. Waiting before starting an antibiotic can save your child from taking medicine that he or she doesn't need.

A child with an ear infection should feel better within 48 hours after taking antibiotics. If your child doesn't feel better, call your doctor. Your child may need a different antibiotic.

Doctors once gave antibiotics over a long period to stop repeat ear infections. Studies show that this method doesn't always work.² Also, using antibiotics too often can lead to new types of bacteria that can't be killed (antibiotic-resistant bacteria). This means that children may not respond to an antibiotic when they really need it, such as if they have pneumonia.

Antibiotics may help with fluid behind the eardrum that won't go away (chronic otitis media with effusion). However, the fluid may return.

Side Effects

Common side effects of antibiotics include:

• Nausea or vomiting.
• Mild diarrhea.
• Another infection, often due to another kind of organism, such as oral thrush or vaginal yeast infections.

Less common and more serious side effects of antibiotics include:

• Skin rashes, hives, or itching.
• Severe allergic reaction (rare).

Use of antibiotics to treat ear infections increases the risk for antibiotic-resistant bacteria.

Children who have been given ceftriaxone may complain of pain at the site of the shot.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

In many countries other than the United States, antibiotics are prescribed much less frequently for ear infections.

Amoxicillin is often the first choice for treating ear infections because it works well, most children can take it, and it's less costly than some other antibiotics.

Experts are looking at how well antibiotics work in clearing ongoing fluid behind the eardrum (chronic effusions). Antibiotics may clear the fluid from behind the eardrum for a short time. Other treatment, such as tube insertion, may help clear fluid from behind the eardrum.

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