What are the treatment options for middle ear infection?

A clinician checks the eardrum and asks about pain, fever, hearing, discharge and how symptoms are changing. Many infections improve with time and need comfort measures rather than an antibiotic. Age, severe pain, symptoms in both ears, discharge, repeated infections and other health conditions can change the plan. Never put cotton buds, oil or unprescribed drops into an ear unless a clinician advises it.

Pain relief may involve a suitable paracetamol or ibuprofen product, used according to the label and the person's age and health. If bacterial infection is suspected or symptoms are severe or persistent, an [Antibiotic Treatment](/treatments/medical-management/antibiotic-treatment/) may be prescribed. Antibiotics do not help viral infections and should not be shared or saved for another illness.

Arrange a [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) if pain is significant, hearing is reduced, fluid is draining, or symptoms are not settling. Encourage rest and fluids, keep water out of a draining ear, and use only recommended medicines. Read more about [Middle Ear Infection](/conditions/middle-ear-infection/) for background on symptoms and assessment.

Seek urgent medical help for swelling or redness behind the ear, a new facial weakness, severe dizziness, a stiff neck, severe headache, confusion, repeated vomiting or a child who is unusually sleepy. Prompt review is also needed if the person is very unwell, pain suddenly worsens, or discharge continues. A very young baby with fever needs same-day clinical advice.

Ask whether the eardrum shows infection, what pain relief is suitable, whether watchful waiting is reasonable, when antibiotics would be needed, and how reduced hearing or repeated episodes will be followed up.