What Is the Best Antibiotic for an Ear Infection?

Published July 17th, 2020 by Bridget Reed
Fact Checked by
Chris Riley

If you’re a parent, you are likely all too familiar with ear infections and the pain and discomfort they can cause your little ones. Most children will experience at least one ear infection at some point in their lives, with five out of six children experiencing at least one ear infection by their third birthday. An acute ear infection, also known as acute otitis media, can be extremely painful. While adults are less likely to get ear infections than kids, it is still possible and extremely uncomfortable. Some ear infections, like middle ear infections, are better treated by antibiotics, while other ear infections are likely to clear up on their own. Parents bring their children to doctors for ear infections more than for any other cause. What is the best antibiotic for an ear infection and how do you know when you need antibiotics?

What Are Ear Infections and What Causes Them?

The term “ear infection” commonly describes inflammation of the middle ear that occurs when fluid builds up behind the eardrum, causing earache pain and pressure. There are three main types of ear infections, including acute otitis media, otitis media with effusion, and chronic otitis media with effusion.

  • Acute otitis media: This is the most common type of ear infection and occurs when the middle ear is infected and swollen due to fluid buildup behind the eardrum. This causes pain and can also sometimes cause a fever.
  • Otitis media with effusion: This type of ear infection most commonly occurs after acute otitis media and is the result of fluid that remains trapped behind the eardrum. Some children with this type of infection experience no symptoms, but a doctor will be able to see the fluid.
  • Chronic otitis media with effusion: This type of ear infection sees the long term buildup of fluid in the middle ear canal that either never goes away or returns chronically. There is no infection present, but the fluid buildup can impact children’s hearing and make it more difficult to fight new infections.

Ear infections have two primary causes: bacterial infection and viral infection. Bacterial ear infections often develop after a child has an upper respiratory infection that spreads from a stuffy nose to a sore throat up to the middle ear. If the upper respiratory infection is caused by bacteria, the same bacteria can infect the middle ear. If the upper respiratory infection is viral, like a cold, bacteria may be attracted to what they perceive as a friendly environment and cause a secondary infection in the middle eartubes. The most common bacteria that cause ear infections are Streptococcus pneumoniae and Haemophilus influenzae.

What Are the Symptoms of Ear Infections?

Young children may have difficulty communicating, but even little ones can usually get the message across when they have side effects of an ear infection. Symptoms of an ear infection include:

  • Ear pain
  • Fussiness or irritability
  • Difficulty sleeping
  • Fever
  • Rubbing or tugging at the ear

At the doctor’s office, your healthcare provider will examine the eardrum to look for signs of infection and fluid buildups, such as a red eardrum or an eardrum with fluid buildup, causing buildup. Many different types of fluid can build up behind the ear, so it may appear as a thin mucus or a thick pus, depending on the cause of the infection. While some ear infections do go away on their own, it’s important to seek medical advice if you or your child experience any of the following symptoms:

  • High fever (102.2 degrees Fahrenheit or higher)
  • Hearing loss
  • Pus, discharge, or fluid leaking from the ear
  • Worsening symptoms
  • Symptoms lasting more than two or three days

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How Are Ear Infections Treated?

Depending on the severity of the ear infection, there are several different approaches when it comes to treatment options. The first approach is to wait and see if the infection goes away on its own while administering over the counter pain relievers, like acetaminophen (Tylenol), ibuprofen (Advil and Motrin). If the infection persists and you visit the doctor, the doctor will try to determine if the ear infection is likely caused by a virus or bacteria. If the infection is suspected to be viral, the doctor will not prescribe antibiotics because the antibiotics cannot treat viral infections. However, if the infection is determined to be bacterial, the doctor will likely prescribe an antibiotic. Viral infections typically clear up more quickly than bacterial infections, so your doctor may take a “wait and see” approach and instruct you to wait a day or two before giving your child antibiotics to see if the infection goes away on its own. 

What Is the Best Antibiotic for an Ear Infection?

Unfortunately, there is no simple answer to which is the best antibiotic for an ear infection because each patient and infection is different. Amoxicillin is one commonly prescribed antibiotic, but some types of bacteria are resistant to it because it is so frequently used. Ciprofloxacin is another commonly prescribed antibiotic that is useful in fighting ear infections. No matter which antibiotic your doctor chooses to prescribe, it is critical that you or your child take the medication exactly as directed and for the full length of the prescription. Your child will likely start feeling better long before the treatment period is up, but stopping antibiotic treatment too soon can allow the infection to come back and can also contribute to increased antibiotic resistance of the bacteria. A follow-up visit to your pediatrician is also important to ensure that the infection is completely gone. 

Can Ear Infections Be Prevented?

There are several steps you can take in order to lower the likelihood that you or your child will experience ear infections. The first is to make sure that you and your child have received the full vaccine schedule that is appropriate for your age based on health information from the American Academy of Pediatrics, the Centers for Disease Control (CDC), and the National Institute of Health (NIH), as this helps to protect against viruses that can encourage ear infections. Studies show that vaccinated children are far less likely to get ear infections than children who are not vaccinated. Also, wash your hands frequently and ensure that your child does the same to prevent the spread of germs. Do not expose yourself or your child to risk factors like cigarette smoke, as this also increases the likelihood of infection.

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