Medications for Middle Ear Infections

Medications for Middle Ear Infections

These pages are meant to give you a general idea about medicine below. Only the most general side effects are listed. Ask your doctor if you need to take any other steps. Use medicine as recommended by your doctor. Ask your doctor or pharmacist if you have other questions.

Some ear infections will pass on their own. Pain medicine can help ease pain until it passes. Many experts recommend that children who are older than 2 years should first try a 2- to 3-day trial with pain medicine alone before trying antibiotics.

Antibiotics might be helpful for certain children with ear infections. This medicine is always used with caution. Using antibiotics when they are not needed can cause germs to become resistant to medicine and make them harder to treat. Talk to your care team about the benefits and risks of using antibiotics.

Medicine for middle ear infections may include:

Prescription Medications

Penicillins

  • Amoxicillin
  • Amoxicillin and potassium clavulanate

Erythromycins

  • Azithromycin
  • Clarithromycin
  • Erythromycin-sulfisoxazole

Cephalosporins

  • Cefdinir
  • Cefpodoxime
  • Cefuroxime
  • Ceftriaxone

Over the Counter Medications

Prescription Medications

All of the prescription medicines are antibiotics. Most will begin with an antibiotic that can kill many types of germs. Other antibiotics may be used if the infection has not cleared as expected. These antibiotics may be better at attacking specific germs.

Penicillin Medications

Common drugs include:

  • Amoxicillin
  • Amoxicillin and potassium clavulanate

Penicillins are used to treat infections caused by a bacteria. They are not helpful against an infection caused by a virus. It may be given as a liquid, chewable tablets, or pill. The medicine may be given as 2 to 3 doses per day for at least 10 days. It may take several days before the infection passes.

Possible side effects include:

  • Rash:
    • May be due to an allergy to penicillin. This can be a serious problem.
    • It can also be a side effect not caused by allergy.
    • Stop taking the medicine and contact the doctor if a rash starts.
  • Anaphylactic (severe allergic) reaction
  • Vaginal itching or burning
  • Nausea, stomach pain, diarrhea

Erythromycin

Common drugs include:

  • Azithromycin
  • Clarithromycin
  • Erythromycin-sulfisoxazole

May be used if you have an allergy to penicillin. These drugs may be given as a liquid or tablet. They are taken 2 to 3 times a day for 7 to 10 days. Some may need to be taken with food. Your care team will let you know what steps need to be taken.

Possible side effects include:

  • Belly pain, nausea, and vomiting which can be severe
  • Allergic reactions, including hives and problems breathing
  • Loose stools, gas
  • Headache

If you have any of these, stop taking the medicine right away. Seek emergency care immediately.

Cephalosporins

Common drugs include:

  • Cefdinir
  • Cefpodoxime
  • Cefuroxime
  • Ceftriaxone

May be given as a liquid or pills. Will be taken 2 to 3 times a day for 7 to 10 days. You should not take these medicines if you have an allergy to cephalosporins. Some children who are allergic to penicillin are also allergic to cephalosporins. Be sure to tell your doctor about any allergies to medicine.

Possible side effects include:

  • Rashes, redness
  • Itching
  • Extreme itching, hives, or faintness after a dose may be serious and need emergency care

Be sure to use the antibiotic as directed. Skipping medicine can lead to an infection that keeps coming back. It can also cause a resistance to antibiotic medicine. Talk with your care team about what to do if you miss a dose.

Over the Counter Medications

Ibuprofen (Advil, Motrin)

Ibuprofen helps to reduce fever, pain, and inflammation. It can help in early days of an ear infection. Ibuprofen can be taken with food or alone. It may cause stomach ache if taken on an empty stomach. Do not use ibuprofen for more than 3 days without talking to your doctor. Follow directions on the label.

Possible side effects include:

  • Belly pain
  • Wheezing, facial swelling or other signs of allergic reaction

Acetaminophen (Tylenol)

Acetaminophen helps reduce pain and fever. It may be easier on the stomach than ibuprofen, but might be less effective in reducing fever. This drug may be taken alone or with food. Be careful of mixing with other medicines that may also have acetaminophen. Some cold medicine may have it included. Read label for active ingredients. Do not use acetaminophen for more than 3 days without talking to your doctor.

Use caution when giving aspirin to children and teenagers. If they are recovering from chickenpox or flu-like symptoms, they should never take aspirin because aspirin has been linked with Reye syndrome. Talk to your medical provider if you have concerns.

Ear Drops

Some ear drops can numb the ear. Medicine may include:

  • Ametocaine
  • Benzocaine
  • Lidocaine

They will give temporary relief of ear pain. They may be used along with pain medicine. Ear drops should not be used if the eardrum has been damaged. Do not use drops if you have or suspect ruptured ear drums.

Ear drops should only be needed for the first 1 to 2 days of treatment if you are having antibiotics. If your pain lasts longer, it may mean that the antibiotic is not working.

When to Contact Your Doctor

  • Continued or worse ear pain after several days of treatment
  • High fever, nausea, vomiting, or diarrhea
  • Hives, a rash, or breathing problems
  • Drainage from the ear
  • Trouble hearing
  • Hard time with balance

Special Considerations

If you are taking medicine, follow these steps:

  • Take the medicine as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your antibiotics.
  • Medicine can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over the counter products and supplements.
  • Plan ahead for refills as needed.

References:

About antibiotic use and resistance. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/getsmart/community/about/index.html/URI/ear-infection.html. Accessed November 16, 2016. Accessed September 27, 2017.
Acute otitis media (AOM) in Adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-otitis-media-in-adults. Updated September 4, 2019. Accessed December 5, 2019.
Acute otitis media (AOM) in Children. EBSCO DynaMed website. Available at: https://www.dyname.... Updated September 4, 2019. Accessed December 5, 2019.
Ear infections in children. National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at:
...(Click grey area to select URL)
Updated May 12, 2017. Accessed December 5, 2019.
Lieberthal AS, Carroll AE, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013 Mar;131(3):e964-e999
Middle ear infections. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Middle-Ear-Infections.aspx. Updated February 22, 2013. Accessed December 5, 2019.
Last reviewed September 2019 by EBSCO Medical Review Board Nicole S. Meregian, PA
Last Updated: 9/2/2020

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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