What Can Happen If An Ear Infection Is Not Treated

What If My Ear Infection Doesnt Go Away After Antibiotics

If you or your child finish your course of antibiotics, but it seems like the ear infection hasnt gone away, make an appointment with your doctor. Theyll help figure out whats going on and what to do next. Theres a chance that your doctor may prescribe a different type of antibiotic to see if it works better.

Its also possible that the infection is gone but the symptoms arent. This can happen if theres still fluid trapped in the ear, causing a plugged-up feeling, pain or hearing loss. Most of the time the fluid in ears drains within a couple of weeks, but sometimes it sticks around longer.

How Can You Treat An Ear Infection At Home

There are a few things you can try to get relief from your pain:

• Use OTC pain medication. Acetaminophen can help with the pain, Dr. Kozin says.
• Get rest. Rest allows your bodys immune system energy to do its job and try to help you heal, says Arashdeep Litt, M.D., an internal medicine physician at Spectrum Health.
• Drink plenty of liquids. Drinking a lot of water can help thin the secretions in your ear rather than keeping them thick, says Omid Mehdizadeh, M.D., an otolaryngologist and laryngologist at Providence Saint Johns Health Center in Santa Monica, Calif. That will help drain mucus in your ear.
• Lie down with the affected ear up. This can help any excess fluid thats behind your eardrum drain through your Eustachian tubes and down your throat, Dr. Mehdizadeh says.
• Use a warm compress. While this wont necessarily help with drainage, it may lessen your pain, Dr. Mehdizadeh says.

It can be tempting to use a cotton swab to see if that will help you get relief, but Dr. Kozin recommends against doing this. One should never put anything in the ear if concerned for an ear infection, such as a cotton tip, as manipulation of the ear can make the infection worse, he warns.

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A Pharmacist Can Help With An Ear Infection

Speak to a pharmacist if you think you have an outer ear infection.

They can recommend acidic eardrops to help stop bacteria or fungus spreading.

• a long-term medical condition such as diabetes or a heart, lung, kidney or neurological disease
• a weakened immune system because of chemotherapy, for example

What You Should Not Do To Soothe A Cold Or Ear Infection:

• Do not give over-the-counter cold medicines to children under age 2. Consider avoiding them if the child is older, too.
• Do not tilt an infants crib mattress. Children under age 1 should sleep on a flat mattress with no pillows or blankets.
• Do not allow a child to drink while lying down, as it can increase the chances of getting an ear infection.
• Do not smoke. Families and caregivers who smoke increase a childs chance of getting colds and ear infections.

Because young children get more colds in the winter, they may also develop more ear infections. Five out of six children will experience at least one ear infection by the time they are 3 years old, according to the National Institutes of Health.

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What Other Treatment Options Are Available

Depending on your symptoms and how severe your ear pain is, your doctor may recommend a wait and see approach. Your bodys immune system can usually fight off middle ear infections on its own, and you may not need to take anything, the Mayo Clinic says. It also depends on the cause of your infection, Dr. Litt says. Viruses dont get better with antibiotics, she points out.

But, if you have a more severe ear infection or your pain has lasted longer than two to three days, your doctor may recommend that you are treated with antibiotics to get relief. Ear infections are typically treated by antibiotics based on the location, Dr. Kozin says. If the infection is located in the outer part of the earthe ear canaltopical antibiotics drops may be used. If the ear infection is behind the eardrum, oral antibiotics are generally used.

What Research Is Being Done

The most important recent development to potentially reduce the frequency of ear infections is a new pneumococcal conjugate vaccine. A study from Northern California suggests that this vaccine could prevent about 7% of overall episodes of ear infections, and up to 23% of recurrent ear infections.

The new pneumococcal vaccine contains 7 of 90 types of pneumococcus, which are the most common and the most resistant bacteria. Elimination of these resistant types could have an impact on the number of antibiotic failures in children. This also could mean a reduction in the placement of tubes, possibly by one-fourth, as observed in the California study.

This vaccine is administered to infants at 2, 4, 6, and 12 months of age. Side effects have been minimal, and it has been a very safe vaccine. It uses the same technology as the universally administered HIB vaccine.

Some new antibiotics are about to undergo testing in children with acute otitis media. In preliminary testing, these drugs appear to work against the resistant pneumococcus.

About the Author

Dr. Block is a full-time practicing pediatrician in rural Bardstown, Kentucky who serves on the clinical faculties at both the University of Kentucky and the University of Louisville as an Associate Clinical Professor of Pediatrics.

His pediatric practice is one of the leading pediatric research groups in the United States and, in fact, Dr. Block was awarded the American Academy of Pediatrics 1998 Practitioner Research Award.

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Treating Middle Ear Infections

You may be prescribed antibiotics. Some antibiotics may be taken orally. Others can be applied directly to the site of the infection with ear drops. Medications for pain, such as over-the-counter pain relievers and anti-inflammatory medications may also be used to manage your symptoms.

If youre still experiencing cold or allergy symptoms, you may be advised to take a , nasal steroids, or an antihistamine.

Another helpful technique is called autoinsufflation. Its meant to help clear your eustachian tubes. You do this by squeezing your nose, closing your mouth, and gently exhaling. This can send air through the eustachian tubes to help drain them.

What Types Of Complications Can Happen

• Bacteremia is bacteria in the blood. Bacteremia can happen when infections in other parts of the body, such as the lungs, kidneys, or skin, travel to the blood. It can also happen when indwelling catheters, such as a central venous access devices, pacemaker wires, or urinary catheters become infected.
• happens when an infection spreads and causes the body to react strongly to the germs. The body’s defense system normally releases chemicals to fight off infection at the infected area. In sepsis, chemicals are released throughout the body. The chemicals cause inflammation and can cause clotting in small blood vessels that is difficult to control. Inflammation and clotting decrease blood flow and oxygen to organs. This may cause them to stop working correctly.
• is a severe type of sepsis that happens as sepsis gets worse and causes multiple organs to shut down. The blood pressure drops very low and organs do not get enough blood. This may cause permanent damage to organs.

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What Are The Types Of Middle

Infections can affect the middle ear in several ways. They are:

• Acute otitis media. This middle-ear infection occurs suddenly. It causes swelling and redness. Fluid and mucus become trapped inside the ear. You can have a fever and ear pain.

• Otitis media with effusion. Fluid and mucus build up in the middle ear after the infection goes away. You may feel like your middle ear is full. This can continue for months and may affect your hearing.

• Chronic otitis media with effusion. Fluid remains in the middle ear for a long time. Or it builds up again and again, even though there is no infection. This type of middle-ear infection may be hard to treat. It may also affect your hearing.

What Are The Symptoms Of A Middle

Common symptoms of a middle-ear infection in adults are:

• Pain in 1 or both ears

• Drainage from the ear

• Sore throat

You may also have a fever. Rarely, your balance can be affected.

These symptoms may be the same as for other conditions. Its important totalk with your health care provider if you think you have a middle-earinfection. If you have a high fever, severe pain behind your ear, orparalysis in your face, see your provider as soon as you can.

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The Causes Behind Ear Infections

The middle ear, located behind the eardrum, is usually a dry area supplied by fresh air through the eustachian tubes. When these tubes become blocked, such as when you have a cold, the middle ear becomes a warm and damp breeding ground for bacteria, which may even enter the area by way of the blocked eustachian tubes.

One reason children suffer from ear infections more often is due to the condition of their youthful eustachian tubes, which can collapse more easily than they will later in life. This leads to blockages creating the germ-laden environments that infections thrive on.

Multiple infections over several months may indicate the eustachian tubes arent functioning well. This could increase the chances of complications resulting from middle ear infections.

How Is It Diagnosed

A doctor will usually diagnose a double ear infection by checking a persons medical history and asking about their symptoms.

The doctor will examine both ears using a device called an otoscope. It comprises a light and a magnifying lens. Doctors typically look for redness, swelling, and signs of fluid behind the eardrum, which indicates infection.

A doctor may also use another device, called a pneumatic otoscope, to test how much the eardrum moves in response to pressure. If the eardrum does not respond to this pressure, it suggests fluid buildup behind the ear.

Many single ear infections clear up on their own. But double infections are more likely to require treatments such as:

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How Are Complications Of Infection Diagnosed

• Measurement of your vital signs may show an abnormal temperature, heart rate, or blood pressure.
• Blood and urine tests will show infection and its cause, organ function, and information about your overall health.
• Blood gases will show how much oxygen and carbon dioxide is in the blood. The results will tell healthcare providers how well your lungs, heart, and kidneys are working.
• An x-ray, ultrasound, CT, or MRI may show the source of infection. You may be given contrast liquid to help the infection show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
• An EKG is a test that records your heart rhythm and how fast your heart beats. It is used to check for abnormal heart rhythms and damage to the heart from infection.
• An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart. The test may show if the infection has spread to the heart valves.
• A lumbar puncture may be done to test your cerebrospinal fluid for germs or signs of infection in or around your brain. CSF is the fluid that surrounds your spinal column and your brain.

Ear Infections: If Not Antibiotics Then What

Your 3-year-old was up half the night crying because of pain in one ear. Hes still tugging on it this morning, but he doesnt have a fever. If youre like most parents, your first instinct will be to take him to the doctor, pronto. Youll ask for a course of antibiotics to make the ear infection go away quickly. After all, its tough to see him feeling uncomfortable. And youd dearly like to avoid more missed days at child care and at work.

Ear infections are common in children. Signs and symptoms include pain in one or both ears , pulling of the ear, difficulty sleeping, difficulty hearing, fever, and vomiting.

Parents often ask for antibiotics to treat ear infections. But these drugs arent always the right choice.

Nipunie S. Rajapakse, M.D., M.P.H., a pediatric infectious diseases specialist at Mayo Clinic in Rochester, Minnesota, says, Ear infections can be caused by both viruses and bacteria. Some of the common cold viruses can cause inflammation of the middle ear.

Up to 80% of ear infections in children get better on their own without drugs. A big reason: Infections caused by viruses have to run their course and dont respond to antibiotics.

Children younger than 2 years old are more likely to be prescribed antibiotics for their ear infections. A wait-and-see approach is generally advised for kids with a temperature less than 102.2 F who are:

Nipunie S. Rajapakse, M.D., M.P.H.

Jason H. Homme, M.D.

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Symptoms Of A Middle Ear Infection

In most cases, the symptoms of a middle ear infection develop quickly and resolve in a few days. This is known as acute otitis media. The main symptoms include:

• a lack of energy
• slight hearing loss – if the middle ear becomes filled with fluid

In some cases, a hole may develop in the eardrum and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves.

What Are Other Causes Of Ear Pain

Other causes of ear pain include:

• A sore throat.
• Teeth coming in in a baby.
• An infection of the lining of the ear canal. This is also called swimmers ear.
• Pressure build up in the middle ear caused by allergies and colds.

Last reviewed by a Cleveland Clinic medical professional on 04/16/2020.

References

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What Are The Causes

Bacteria or viruses in the middle ear cause ear infections.

A person who has, or had, an upper respiratory infection may also develop an ear infection. Ear infections are not contagious. However, the respiratory infections that might accompany an ear infection are.

Enlarged adenoids, which are pads of tissue at the back of the nose, may also contribute to a double ear infection, especially in children.

An infection affecting only one ear may also occasionally develop into a double ear infection.

Hearing difficulties are probably the most common short-term complication of a double ear infection.

A persons hearing will typically return to normal once the infection clears up.

Persistent or recurrent infections can lead to:

• Hearing problems: Permanent damage to structures within the ear can cause hearing loss of varying degrees.
• Ruptured eardrum: A torn eardrum may occur after severe ear infections. It will usually heal within a few weeks.
• Delays in speech and development: Infants and toddlers who experience a prolonged hearing loss may experience delays in their speech and development.
• Spread of infection: As with all infections, there is a risk that a double ear infection will spread to other areas of the body.

Long-term complications following ear infections are uncommon.

When Else Are Antibiotics Needed

Antibiotics can be the right treatment for kids who get a lot of ear infections. Their doctors might prescribe daily antibiotics to help prevent future infections. And younger children or those with more severe illness may need antibiotics right from the start.

The “wait-and-see” approach also might not apply to children with other concerns, such as cleft palate, genetic conditions such as Down syndrome, or other illnesses such as immune system disorders.

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How Do Ear Infections Happen

A middle ear infection usually happens because of swelling in one or both of the eustachian tubes . The tubes let mucus drain from the middle ear into the throat.

A cold, throat infection, acid reflux, or allergies can make the eustachian tubes swell. This blocks the mucus from draining. Then, or grow in the mucus and make pus, which builds up in the middle ear.

When doctors refer to an ear infection, they usually mean otitis media rather than swimmer’s ear . Otitis media with effusion is when noninfected fluid builds up in the ear. It might not cause symptoms, but in some kids, the fluid creates a sensation of ear fullness or “popping.”

Can Ear Infections Affect Hearing

Fluid buildup in the middle ear also blocks sound, which can lead to temporary hearing problems. Kids having a problem might:

• not respond to soft sounds
• need to turn up the TV or radio
• talk louder
• seem inattentive at school

In kids who have otitis media with effusion, the fluid behind the eardrum can block sound, so mild temporary hearing loss can happen, but might not be obvious.

A child whose eardrum has ruptured might have ringing or buzzing in the ear and not hear as well as usual.

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