Middle Ear Infection Symptoms and Treatment

The ear has three main parts, outer ear, middle ear, and inner ear. Sound waves travel through outer ear, reach the middle ear and finally vibrations travel to inner ear.

A variety of conditions affect your hearing and ear infections are the most common. Ear infection, most commonly is an inflammation and infection of the middle ear.


There are two types of ear infection that develops in adults and may include:

Outer ear infections: This type of ear infection is more common among swimmers and hence known as swimmer’s ear or otitis externa. It is the painful condition caused by infection of the outer ear.

While swimming the polluted water gets trapped into the ear along with bacteria and other microorganisms and cause infection. This type of ear infection is more common in adults

Acute middle ear infections: This type of ear infection is more common in children due to, smaller eustachian tube size due to which draining out the pus becomes difficult. It is also called as otitis media.


The most common cause of ear infection is bacterial or viral infections. These bacteria or viruses enter the ears if the individual is suffering from cold, flu or allergy or other breathing problems and spread the infection to the middle ear.


Some of the commonly observed symptoms of ear infection are ear redness, itching inside the ear, pus drainage, flaking of the skin, feeling of blockage, ear pain, dizziness, fever and hearing loss.


Your doctor performs physical examination by examining the throat, head, neck, and ears and asks your personal and family history. Using otoscope, a lighted instrument your doctor will look inside your ear, for presence of a red bulge, or air bubbles, or fluid which indicates that the ear is infected.

Pneumatic otoscope test is a diagnostic test used to check the accumulation of fluid on the eardrum.

In this test, your doctor blows air into your ear; in normal cases the ear drum moves front and back when air is blown, but in an infected ear, the ear drum does not move, which is a clear sign of accumulation of fluid.

Your doctor may suggest for a hearing test in individuals who have frequent ear infections.

Most middle ear infections (otitis media) will clear up within three days and don’t need any specific treatment.

You can relieve any pain and a high temperature using over the counter painkillers such as paracetamol and ibuprofen. However, aspirin should not be given to children under 16 years of age.

Placing a warm flannel or washcloth over the affected ear may also help relieve pain until the condition passes.

Complications of ear infection

Ear infections, if left untreated may cause several complications such as meningitis, chronic and recurrent infection, formation of cysts, enlarged adenoid glands, spread of infection to brain tissues, delayed speech, and hearing loss.

Therefore early diagnosis and treatment will prevent further complications.


Practicing certain measures may prevent the ear infections:

  • Keep the ears clean and dry
  • Avoid swimming in contaminated water
  • Washing the hands before touching the ears
  • Dry the ear completely after exposure to moist conditions
  • Wear ear plugs while swimming
  • Avoid scratching the ears
  • Avoid use of cotton swabs or other objects in the ear


In most cases, an ear infection in an adult is initially treated with antibiotics. Amoxicillin is generally prescribed antibiotic. Acetaminophen (Tylenol) may be prescribed to reduce the pain and fever caused by ear infection.

Surgery is very rarely recommended in cases if the antibiotics fail to clear the infections and in cases of recurrent infections. Surgery involves placement of tympanostomy tube, a small ventilating tube in the eardrum.

This tube allows the air to pass in allowing the fluid to drain out and also prevents the fluid accumulation behind the ear.


The routine use of antibiotics to treat middle ear infections is not recommended as there is no evidence that they speed up the healing process. Many cases are caused by viruses, which antibiotics are ineffective against.

Using antibiotics to treat minor bacterial infections also increases the likelihood of bacteria becoming resistant to them over time.

This means more serious infections could become untreatable in the future. Read about antibiotic resistance for more information.
Antibiotics are therefore usually only considered if:

your child has a serious health condition that makes them more vulnerable to complications, such as cystic fibrosis or congenital heart disease

  • your child is less than three months old, or they are less than two years old and have an infection in both ears
  • your child’s symptoms are severe
  • your child has discharge coming from their ear
  • your child’s symptoms show no signs of improvement after four days

If antibiotics are needed, a five-day course of an antibiotic called amoxicillin is usually prescribed. This is often given as a liquid suspension that your child has to drink. Common side effects of amoxicillin include a rash, feeling sick and diarrhoea.

If your child is allergic to amoxicillin, an alternative antibiotic such as erythromycin may be used.

In some cases, your GP may give you a prescription that you can choose to pick up a few days later if your child’s condition hasn’t improved by then.

Adults and children who develop a long-term middle ear infection (chronic suppurative otitis media) may benefit from short courses of antibiotic ear drops.

Source & More Info: Dr. David Lowinger and NHS.uk



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