What if antibiotic treatment does not relieve earache?

Ear pain has several possible causes. Infection in the middle ear, the ear canal, pressure behind the eardrum, a blocked nose, dental problems, or irritation can feel similar. Antibiotics only help particular bacterial infections, and pain or pressure may take time to ease while tissues recover. A clinician may examine the ear canal and eardrum and ask about hearing change, discharge, fever, recent swimming, and jaw or tooth pain. Ongoing symptoms do not by themselves show that a stronger antibiotic is needed.

Take the prescribed medicine as directed and speak with the prescriber if the pain is not settling, becomes worse, or returns. Keep water and objects out of the ear, and do not put drops in it unless a clinician has recommended them. Use a suitable pain reliever only according to its instructions and your personal medical advice. Mention allergies, pregnancy, kidney or stomach problems, and other medicines when asking about pain relief. The review may identify a need for local ear treatment, treatment of nasal congestion, or assessment of a nearby source of pain.

Seek urgent help for swelling or severe tenderness behind the ear, a new facial weakness, severe dizziness, confusion, a severe headache, or a very unwell appearance. Prompt assessment is needed for sudden hearing loss, heavy discharge or bleeding, or pain after an injury. Children who are difficult to wake, struggling to drink, or deteriorating quickly also need urgent attention.

Ask: Which part of the ear appears affected? Could the pain come from my teeth, jaw, or throat? Is the eardrum intact? Should I use drops or keep the ear dry? What signs mean I should return quickly?