Ear Infection: Should I Give My Child Antibiotics?
Ear Infection: Should I Give My Child Antibiotics?Skip to the navigationYou may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Ear Infection: Should I Give My Child Antibiotics?Get the factsYour options- Wait and see if the ear infection clears up on its
own.
- Give your child antibiotics.
Key points to remember- This topic is only appropriate for
children 6 months and older. Most ear infections clear up on their own. Antibiotics do not
help with ear pain immediately. You can treat pain at home with pain relievers and by
putting a warm washcloth on your child's ear.
- If
your child is age 6 months 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.
- Doctors usually prescribe
antibiotics if a child:footnote 1
- Is younger than 2 and has an infection in both ears or has more than mild pain or fever.
- 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.
- Has cochlear implants.
- 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 A middle 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 young children 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 temporary loss of hearing. Fever lasts about 1 to 2
days. 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. 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.
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 6 months and older won't
need antibiotics. Up to 80 out of 100 ear infections get better on their own,
while 20 out of 100 don't.footnote 2 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). Read and follow all instructions on the label. If you give medicine to your baby, follow your doctor's
advice about what amount to give. Do not give aspirin to anyone younger than 20. Aspirin has been linked to Reye syndrome, a
serious illness.
- Put a warm washcloth on the ear.
- Help your child rest by arranging quiet play.
- Give your child eardrops for pain if your doctor prescribes
them.
Doctors usually prescribe antibiotics if a
child: - Is younger than 6 months, because infections at this age are less likely to go away during watchful waiting. And normal hearing is very important when a young child is learning to talk.
- 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.
- Has cochlear implants. Children who have these hearing devices are at risk for more serious infection.
Compare your options | |
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What is usually involved? |
| |
|---|
What are the benefits? |
| |
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What are the risks and side effects? |
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Give your child
antibiotics Give your child
antibiotics - Your child takes
antibiotics for several days. The antibiotic may be a
pill or a liquid.
- Even if your child seems well, he or she may need a follow-up visit in
about 4 weeks, especially if your child is young.
- 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 on the
ear.
- Rest.
- Eardrops if your doctor prescribes
them.
- You follow your doctor's advice about bathing, swimming, and
other activities.
- 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.
- 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.
Wait and see Wait and see - 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 on the
ear.
- Rest.
- Eardrops if your doctor prescribes
them.
- You follow your doctor's advice about bathing, swimming, and
other activities.
- Even if your child seems well, he or she may need a follow-up visit in
about 4 weeks, especially if your child is young.
- 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.
- 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.
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 medicine 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. 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? 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. 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. What matters most to you?
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: My other important reasons: More important Equally important More important Where are you leaning now?
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.
Leaning toward Undecided Leaning toward What else do you need to make your decision?1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure Your SummaryHere's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Next stepsWhich way you're leaningHow sure you areYour commentsKey concepts that you understoodKey concepts that may need reviewCredits | Author | Healthwise Staff |
|---|
| Primary Medical Reviewer | Susan C. Kim, MD - Pediatrics |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | John Pope, MD - Pediatrics |
|---|
References Citations - American Academy of Pediatrics and American Academy of Family Physicians (2013). Clinical practice guideline: Diagnosis and management of acute otitis media. Pediatrics, 131(3): e964-e999.
- Venekamp RP, et al. (2014). Acute otitis media in children. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/0301/overview.html. Accessed April 14, 2016.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Ear Infection: Should I Give My Child Antibiotics?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. - Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Wait and see if the ear infection clears up on its
own.
- Give your child antibiotics.
Key points to remember- This topic is only appropriate for
children 6 months and older. Most ear infections clear up on their own. Antibiotics do not
help with ear pain immediately. You can treat pain at home with pain relievers and by
putting a warm washcloth on your child's ear.
- If
your child is age 6 months 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.
- Doctors usually prescribe
antibiotics if a child:1
- Is younger than 2 and has an infection in both ears or has more than mild pain or fever.
- 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.
- Has cochlear implants.
- 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 a middle ear infection?A middle 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 young children 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 temporary loss of hearing. Fever lasts about 1 to 2
days. 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 6 months and older won't
need antibiotics. Up to 80 out of 100 ear infections get better on their own,
while 20 out of 100 don't.2 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). Read and follow all instructions on the label. If you give medicine to your baby, follow your doctor's
advice about what amount to give. Do not give aspirin to anyone younger than 20. Aspirin has been linked to Reye syndrome, a
serious illness.
- Put a warm washcloth on the ear.
- 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?Doctors usually prescribe antibiotics if a
child: - Is younger than 6 months, because infections at this age are less likely to go away during watchful waiting. And normal hearing is very important when a young child is learning to talk.
- 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.
- Has cochlear implants. Children who have these hearing devices are at risk for more serious infection.
2. Compare your 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.
- Even if your child seems well, he or she may need a follow-up visit in
about 4 weeks, especially if your child is young.
- 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 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 on the
ear.
- Rest.
- Eardrops if your doctor prescribes
them.
- You follow your doctor's advice about bathing, swimming, and
other activities.
- Even if your child seems well, he or she may need a follow-up visit in
about 4 weeks, especially if your child is young.
|
|---|
| 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 storiesPersonal 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 medicine 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." "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?" "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." "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." 3. What matters most to you?
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: My other important reasons: More important Equally important More important 4. Where are you leaning now?
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.
Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?
Check the facts
1.
Should all children get antibiotics for an ear infection? You're right. Most ear infections clear up on their own. 2.
Do antibiotics relieve ear pain immediately? That's right. Antibiotics do not relieve ear pain immediately. Your child may need to take an over-the-counter medicine for pain. 3.
Can antibiotics have bothersome side effects? That's right. Antibiotics can have bothersome side effects, such as vomiting, diarrhea, and an allergic reaction. Decide what's next1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty1.
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. Credits | By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Susan C. Kim, MD - Pediatrics |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | John Pope, MD - Pediatrics |
|---|
References Citations - American Academy of Pediatrics and American Academy of Family Physicians (2013). Clinical practice guideline: Diagnosis and management of acute otitis media. Pediatrics, 131(3): e964-e999.
- Venekamp RP, et al. (2014). Acute otitis media in children. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/0301/overview.html. Accessed April 14, 2016.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Current as of:
May 4, 2017 American Academy of Pediatrics and American Academy of Family Physicians (2013). Clinical practice guideline: Diagnosis and management of acute otitis media. Pediatrics, 131(3): e964-e999. Venekamp RP, et al. (2014). Acute otitis media in children. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/0301/overview.html. Accessed April 14, 2016. Last modified on: 8 September 2017
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