Ear infection: Should I give my child antibiotics?

1. Get the Facts

Your options

Wait and see if the ear infection clears up on its own.
Give your child antibiotics.

Key points to remember

Most ear infections clear up on their own. Antibiotics do not help with ear pain. You can treat pain at home with pain relievers and by putting a warm washcloth or heating pad on your child's ear.
If your child is age 2 or older and has a mild earache, you can wait for up to 48 hours to see if the infection gets better on its own. Talk to your doctor if your child's pain doesn't get better with an over-the-counter pain reliever (such as acetaminophen) or if other symptoms last for more than 48 hours.
Your doctor may decide to prescribe antibiotics right away if your child:
- Is younger than 2. The risk of problems in speech development from trouble hearing is higher for very young children.
- Is very ill from the infection. For example, your child may be dehydrated.
- Has other health problems, such as cleft palate or repeat infections that could put him or her at risk for serious problems from an ear infection.
If your doctor prescribes antibiotics, you may have to wait at least another 48 hours for the medicine to take effect.
Antibiotics can have side effects, such as vomiting, diarrhea, and an allergic reaction.
Taking antibiotics when they're not needed can make it hard for these medicines to work the next time your child needs them. This can happen because bacteria can build up resistance to the medicine.

FAQs

What is an ear infection?

An ear infection, also called otitis media, is inflammation or infection of the middle ear . Ear infections often occur along with a cold or other upper respiratory infections. Almost all children have at least one ear infection before age 7.

Most ear infections are caused by bacteria. But viruses also can cause them. The respiratory syncytial virus (RSV) and the influenza (flu) virus are the two main viruses that cause ear infections.

Ear infections are most common in young children because they have shorter eustachian tubes, which are more easily blocked than those of older children and adults. When the tube is blocked, fluid builds up. This creates a breeding ground for germs.

Pus forms as the body tries to fight the infection. More fluid collects and pushes against the eardrum, causing pain and sometimes a loss of hearing. Fever lasts about 1 to 2 days. Pain and crying usually last for 3 to 4 hours. Most children have some pain on and off for up to 4 days. Young children may have pain that comes and goes for up to 9 days.

How can you tell if your child has an ear infection?

If your child has an ear infection, he or she may:

Have an earache. It may be mild, or it may hurt a lot.
Act fussy (babies or young children) or grumpy.
Pull at his or her ears.
Have trouble sleeping.
Have trouble hearing.
Have a fever.
Not feel like eating.
Vomit.

Most parents will know that these symptoms point to an ear infection after their children have had a couple of ear infections. But a visit to the doctor is the only way to know for sure. Your child's doctor can diagnose an infection by looking at your child's ears with a tool called an otoscope.

How well do antibiotics clear up ear infections?

Antibiotics work most of the time to treat ear infections caused by bacteria. But they won't treat ear infections caused by viruses.

No matter what causes the infection, most children won't need antibiotics. Up to 80 out of 100 ear infections get better on their own, while 20 out of 100 don't.¹

For this reason, the American Academy of Pediatrics recommends waiting for a couple of days to see if an ear infection gets better before you try antibiotics.

How can you treat your child's ear infection at home?

You can help ease your child's pain at home, whether you use antibiotics or wait for the ear infection to get better on its own.

You can:

Give your child an over-the-counter pain reliever like acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin). Do not give aspirin to anyone younger than 20. Aspirin has been linked to Reye syndrome, a serious illness.
Put a warm washcloth or heating pad on the ear. Don't let your child go to bed with a heating pad, because he or she could get burned. Use a heating pad only if your child is old enough to tell you if it's getting too hot.
Help your child rest by arranging quiet play.
Give your child eardrops for pain if your doctor prescribes them.

Why might your doctor recommend antibiotics for an ear infection?

Your doctor might recommend antibiotics if your child:

Is younger than 2. The risk of problems in speech development from trouble hearing is higher for very young children.
Is very ill from the infection. For example, your child may be dehydrated.
Has other health problems, such as cleft palate or repeat infections that could put him or her at risk for serious problems from an ear infection.

2. Compare Options

	Give your child antibiotics	Wait and see
What is usually involved?	Your child takes antibiotics for several days. The antibiotic may be a pill or a liquid. Sometimes the first dose is given in a shot. If your child is younger than 3, he or she probably will have a follow-up visit in about 4 weeks to check his or her hearing. You help ease your child's pain at home with: Over-the-counter pain relievers (except for aspirin, which shouldn't be given to anyone younger than 20). A warm washcloth or heating pad on the ear. Rest. Eardrops if your doctor prescribes them. You follow your doctor's advice about bathing, swimming, and other activities.	You help ease your child's pain at home with: Over-the-counter pain relievers (except for aspirin, which shouldn't be given to anyone younger than 20.) A warm washcloth or heating pad on the ear. Rest. Eardrops if your doctor prescribes them. You follow your doctor's advice about bathing, swimming, and other activities. If your child is younger than age 3, he or she probably will have a follow-up visit in about 4 weeks to check his or her hearing.
What are the benefits?	They work most of the time to clear up ear infections. In children under age 2 or who are very sick, antibiotics may prevent problems from the infection, such as trouble with speech development.	Most ear infections get better on their own. You don't have the possible side effects and cost of antibiotics. You reduce the chance that antibiotics won't work in the future because of overuse. If your child isn't better after a couple of days, you can ask your doctor for antibiotics.
What are the risks and side effects?	Side effects may include vomiting, diarrhea, and an allergic reaction. Using antibiotics too often for ear infections can make it hard for the medicines to work the next time your child needs them. These medicines can cost a lot.	Some ear infections don't get better on their own. Your child's infection may last a little longer than if he or she took antibiotics.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

For more information, see the topic Ear Infections.

Personal stories from parents whose children had ear infections

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My daughter, Biba, is a wonderfully robust 4-year-old. When she complained of an earache after a cold, we visited our doctor. She told us the ear infection would probably go away on its own, so I decided not to fill the prescription my doctor gave me then. The doctor said to give Biba pain relief medication for the next few days and if she didn't improve in 2 days that I should fill the prescription and have Biba take the antibiotics. Biba stayed home from school for 1 day, but she felt better the next. Best of all, she didn't have to take antibiotics. "

— Maureen, age 33

"My son, Rashad, has had so many ear infections. He really suffers with them. When the doctor said that I could wait to see if it would clear up, I thought that he would probably need antibiotics anyway, so why wait? "

— Renee, age 35

"I am very concerned about bacteria that are not affected by antibiotics. My friend's child had to take very strong antibiotics to cure his ear infection. When my son, Maury, got an ear infection, I waited to see if he would improve. But he still had an earache after 2 days, so I decided to go ahead and have him take antibiotics. "

— Briana, age 41

"I am a working single mother with three kids. I don't have time to stay home and see if my son, Darrell, will get better. I need the fastest and most certain cure. So I decided he should take the antibiotics now. "

— Cecelia, age 22

3. Your Feelings

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to give your child antibiotics

Reasons to wait and see

I'm not worried about the risk of side effects from antibiotics.

I'm worried that my child could have side effects from antibiotics.

More important

Equally important

More important

I want to get my child's infection taken care of now.

I'm willing to wait a couple of days for the infection to go away on its own.

More important

Equally important

More important

I'm not concerned that using antibiotics a lot could make them not work in the future.

I'm concerned that antibiotics might not work in the future if my child uses them a lot.

More important

Equally important

More important

I can afford antibiotics.

I don't want to spend money on medicine my child may not need.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Your Decision

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Using antibiotics

Waiting

Leaning toward

Undecided

Leaning toward

5. Quiz Yourself

Check the facts

1. Should all children get antibiotics for an ear infection?

Yes
No
I'm not sure

You're right. Most ear infections clear up on their own.

2. Do antibiotics relieve ear pain?

Yes
No
I'm not sure

That's right. Antibiotics do not relieve ear pain. Your child will need to take an over-the-counter medicine for pain.

3. Can antibiotics have bothersome side effects?

Yes
No
I'm not sure

That's right. Antibiotics can have bothersome side effects, such as vomiting, diarrhea, and an allergic reaction.

Decide what's next

1. Do you understand the options available to you?

Yes
No

2. Are you clear about which benefits and side effects matter most to you?

Yes
No

3. Do you have enough support and advice from others to make a choice?

Yes
No

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.