Cure an Ear Infection

Ear infections (also known as otitis media) are a common problem for infants and children, but they can occur in adults as well. Nearly 90% of children will have at least one ear infection by age three.[1] Infections can become quite painful because the buildup of fluids puts pressure on the eardrum.[2] Many infections clear up on their own with home ear infection treatment, but more severe cases, or those that occur in younger children, may require prescription antibiotics to cure the ear infection completely.[3]

Steps

Identifying an Ear Infection

  1. Know who is most at risk for an ear infection. In general, children are more likely to get ear infections than adults. This is because the eustachian tubes (tubes running from the middle of each ear to the back of your throat) are smaller in children and more prone to fill with fluid. Children also have weaker immune systems than adults and are also more prone to viral infections such as colds.[4] Anything that blocks the eustachian tube can cause an ear infection. There are other risk factors for an ear infection, including:[5]
    • Allergies
    • Respiratory infections such as colds and sinus infections
    • Infection or trouble with the adenoids (lymph tissue in your upper throat area)
    • Tobacco smoke
    • Excess mucus or saliva, such as that produced during teething
    • Living in a cold climate
    • Changes in altitude or climate
    • Not being breastfed as an infant
    • Recent illness
    • Attending daycare, especially a larger daycare with many children
  2. Recognize the symptoms of a middle ear infection. A middle ear infection (acute otitis media) is the most common type of ear infection and is caused by a virus or bacteria.[5] The middle ear is the space just behind the eardrum that contains the small bones that pass vibrations to the inner ear. When the area becomes filled with fluid, bacteria and viruses can get in and cause an infection.[6] An ear infection often occurs after a respiratory infection such as a cold, although severe allergies may also bring one on.[7] Symptoms of a middle ear infection include:[5][7]
    • Ear pain or an earache
    • Feeling of fullness in the ear
    • Feeling ill
    • Vomiting
    • Diarrhea
    • Hearing loss in the infected ear
    • Tinnitus
    • Dizziness
    • Ear drainage
    • Fever, especially in children
  3. Distinguish between a middle ear infection and “swimmers’ ear.” Swimmers’ ear, also known as otitis externa or an “external ear infection,” is an infection of the outer ear canal caused by bacteria or fungi. Moisture is a common culprit for this type of infection (hence the name), but scratching or inserting things into the ear canal can also leave you prone to infection.[7] Symptoms may begin as mild but often worsen, and include:[8]
    • Itching in your ear canal
    • Redness inside the ear
    • Discomfort that worsens if you pull or push on your outer ear
    • Ear drainage (begins clear and odorless, may progress to pus)
    • More severe symptoms include:
      • Feeling of fullness or blockage
      • Decreased hearing
      • Severe pain that radiates outward to your face or neck
      • Swelling of neck lymph nodes
      • Fever
  4. Look for signs of ear infection in children. Young children may display different symptoms of ear infection than older children and adults. Because young children often cannot communicate how they’re feeling, look for the following symptoms:[9]
    • Tugging, pulling or scratching the ear
    • Banging the head around
    • Fussiness, irritability, or incessant crying
    • Difficulty sleeping
    • Fever (especially for infants and very young children)
    • Fluid drainage from the ear
    • Clumsiness or balance problems
    • Trouble hearing
  5. Know when to seek immediate medical attention. Most ear infections can be treated at home, and many go away on their own. However, if you or your child experience certain symptoms, you should contact your doctor immediately. These symptoms include:[7]
    • Blood or pus in ear drainage (may look white, yellow, green, or pinkish/red)
    • Continued high fever, especially if it is over 102F (39C)
    • Dizziness or vertigo
    • Stiff neck
    • Tinnitus
    • Pain or swelling behind or around the ear
    • Ear pain that lasts more than 48 hours

Seeking Medical Attention

  1. Take your child to the doctor if s/he is younger than six months old. If you notice any symptoms of ear infection in an infant, take him or her to the doctor immediately.[5] Infants at this age have not fully developed their immune systems. They are at a much higher risk for serious infections and will likely need immediate antibiotics. [10]
    • Do not try home remedies on infants and very young children. Always consult your pediatrician for the most appropriate route of care.
  2. Allow the doctor to examine your ears or your child’s ears. If you suspect that you or your child have a serious ear infection, prepare for tests such as:[11]
    • A visual examination of the eardrum using an otoscope. It may be difficult to get your child to sit still for this exam, but it’s an important test to determine if the child has an ear infection.
    • An examination of any blockage or filling of the middle ear using a pneumatic otoscope, which will blow a little air at the eardrum. The air will cause the eardrum to move back and forth. If fluid is present, the eardrum will not move as easily or readily, which indicates a likely ear infection.[12]
    • An examination with a tympanometer, which uses sound and air pressure to check for any fluid in the middle ear.
    • If the infection is chronic or a severe case, an audiologist may perform a hearing test to determine if there is any hearing loss.
  3. Be prepared for the doctor to examine the eardrum more closely in case of a stubborn or chronic infection. If you or your child becomes quite ill as a result of ear issues, your doctor may make an opening in the eardrum and draw out a sample of fluid from the middle ear. S/he will then send these samples to a lab to have them tested.[11]
  4. Keep in mind that you can treat many ear infections at home. Many ear infections go away on their own without treatment. Some ear infections may disappear within a few days, and most ear infections will disappear on their own within 1-2 weeks, even if you don’t treat them. The American Academy of Pediatrics and the American Academy of Family Physicians suggest a “wait-and-see approach” with the following guidelines:[13]
    • Children 6 to 23 months old: Wait and see if the child has mild inner ear pain in one ear for less than 48 hours and a temperature less than 102.2 F (39 C).
    • Children 24 months and older: Wait and see if the child has mild inner ear pain in one or both ears for less than 48 hours and a temperature less than 102.2 F (39 C).
    • Past 48 hours, it is important to see a doctor. Often you or your child will be started on an antibiotic to prevent the infection from spreading and reduce the chance of rare life-threatening infections.
    • Rarely, more serious complications may develop, including mastoiditis (an infection of the bones around the skull), meningitis, infection spreading to the brain, or hearing loss.[14]
  5. Use caution when flying with a child who has an ear infection. Children with active ear infections are at a higher risk of a painful condition called barotrauma, which is experienced when the middle ear attempts to adjust to the changes in pressure. Chewing gum during ascent and descent can decrease the risk of this.[15]
    • If you have an infant with an ear infection, bottle-feeding during ascent and descent can help regulate the pressure in the middle ear.

Treating Ear Infection Pain at Home

  1. Take over-the-counter pain medication. Ibuprofen or acetaminophen can be taken if the pain does not diminish on its own or if other symptoms don't develop. These medications can also help reduce your child’s fever and can make him or her feel better.
    • Never give children under the age of 18 aspirin as this has been linked to Reye's syndrome, which can result in brain damage and liver problems.[16]
    • Use child-strength formulations when giving any pain reliever to children. Follow the dosing recommendations on the package or ask your pediatrician.
    • Do not give ibuprofen to children under the age of 6 months.
  2. Apply a warm compress. A warm compress will help lessen the pain of an ear infection. You can use a warm, damp washcloth.[13]
    • You can also fill a clean tube sock with rice or beans and tie or sew the open end of the sock shut. Microwave the sock for 30 seconds at a time until it is the desired temperature. Apply the compress to the ear.[17]
    • You can also use salt as a natural remedy. Heat one cup of salt and place it in a cloth. Tie it up with a rubber band and place it on the affected ear for 5-10 minutes when it’s bearably hot while lying down.
    • Apply the warm compress for 15-20 minutes at a time.[7]
  3. Get plenty of rest. Your body needs rest to recover from infections.[7] Make sure that you do not push yourself too hard while you have an ear infection, particularly if you also have a fever.
    • Pediatricians do not recommend that you keep a child home from school for an ear infection unless s/he has a fever.[18] However, you should probably monitor your child’s activity to make sure s/he gets the rest s/he needs.
  4. Stay hydrated. Particularly if a fever is present, you should drink extra fluids.[7]
    • The Institute of Medicine recommends that you drink at least 13 cups (3 liters) of fluids daily if you are male, and at least 9 cups (2.2 liters) of fluids daily if you are female.[19]
  5. Try Valsalva's Maneuver if no pain is present. The Valsalva's Maneuver can be used to open up the eustachian tubes and relieve the "stuffed up" feeling that may occur with an ear infection. You should only do this maneuver if you do not currently have ear pain.[20]
    • Take a deep breath and close your mouth.
    • Pinch your nose shut. Then, while pinching the nose, "blow" your nose gently.
    • Do not blow too hard, or you could damage your eardrum. You should feel your ears "pop."
  6. Place a few drops of warm mullein or garlic oil in your ear. Mullein and garlic are natural antibiotics and may also provide soothing relief from ear infection pain. If garlic oil is not available, you can prepare it at home. All you need is, cook 2 garlic cloves in 2 tablespoons of mustard or sesame oil until it turns blackish. Cool this oil and use a eyedropper to place 2-3 drops of warm (never hot) oil in each ear.[21]
    • You should always consult with a pediatrician before trying this with children.
  7. Try a naturopathic remedy. One study suggests that a naturopathic herbal remedy called Oticon Otic solution (Healthy-On) may be helpful in reducing ear pain from ear infections. [22]
    • Consult your doctor before using this remedy. Never give any alternative medications to your child without consulting your pediatrician first.

Observing the Condition

  1. Monitor the ear condition carefully. Check your temperature or your child’s temperature frequently and watch for other symptoms.
    • If a fever develops or you observe flu-like symptoms such as nausea or vomiting, this can possibly mean the infection is getting worse and that home ear infection treatments are not working effectively.
    • Symptoms that necessitate a trip to your doctor include confusion, neck stiffness, and swelling, pain, or redness around the ear. These symptoms indicate that the infection may have spread and that it needs immediate treatment.
  2. Notice if you feel severe ear pain followed by no pain at all. This could indicate the eardrum has ruptured. Ruptured eardrums can result in temporary loss of hearing. They can also make your ear more susceptible to infections, making the situation even worse.[23]
    • In addition to the absence of pain, there may also be drainage coming from the ear.
    • Although ruptured eardrums usually heal within a couple weeks, even without treatment, some problems may persist that require medical intervention or treatment.[24]
  3. Call your doctor if your pain worsens within 48 hours. While most doctors recommend a 48-hour “wait and see” approach, if you experience worsening pain during that period, call your doctor. Your doctor will be able to recommend more intense treatment or antibiotics.[25]
  4. Get your hearing or your child’s hearing tested if fluid buildup in the ear continues after 3 months. This may be coupled with significant hearing problems.[26]
    • Sometimes, a short-term hearing loss can occur, which is especially concerning for children two years and younger.
    • If your child is younger than 2 and experiencing fluid buildup as well as hearing issues, your doctor may not wait three months to start treatment. Hearing problems at this age could affect your child’s ability to speak and lead to other developmental problems.

Using Antibiotics and Medical Treatments

  1. Get a prescription for antibiotics from your doctor. Antibiotics will not help an ear infection that is caused by a virus, so doctors do not always prescribe antibiotics for ear infections. All children under 6 months old will be treated with antibiotics.[5]
    • Tell your doctor about the last time you used antibiotics, as well as what kind. This will help your doctor choose the most effective kind for you.
    • Make sure you or your child take all the doses of the medication on schedule, to ensure the infection does not return.
    • Do not stop taking antibiotics, even if you feel better until you have completed the entire course as prescribed. Stopping antibiotic treatment before you finish the full course can cause any remaining bacteria to become resistant to antibiotics, making the condition much more difficult to treat.[27]
  2. Ask your doctor for prescription ear drops. Ear drops, such as antipyrine-benzocaine-glycerin (Aurodex), may help relieve the pain of ear infections. A doctor will not prescribe ear drops to people with torn or perforated eardrums.[13]
    • To give drops to a child, first warm up the eardrop solution by placing the bottle in warm water or holding it between your hands for a few minutes.[28] Have your child lie on a flat surface with the infected ear facing up toward you. Use the recommended dosage. Have your child keep his or her head tilted with the infected ear up for about 2 minutes.
    • Because benzocaine is a numbing agent, it’s best if you can have someone else apply the drops to your ear. Avoid touching your ear with the dropper.[28]
    • Benzocaine may cause mild itchiness or redness. It has also been linked to a rare but serious condition that affects your blood’s oxygen levels. Never use more than the recommended dose of benzocaine, and consult your pediatrician to make sure that you give the right dosage to your child.[13]
  3. Ask your doctor about ear tubes if the ear infection is recurrent. Recurring otitis media may require a procedure called a myringotomy. Recurring means you have had three episodes in the past six months or four episodes in the past year, with at least one occurring in the past six months. An ear infection that does not clear up after treatment is also a candidate for this procedure.[13]
    • Ear tube surgery, or myringotomy, is an outpatient procedure. A surgeon inserts tiny tubes into the eardrum so fluids behind the eardrum can drain easier. The eardrum usually closes up again after the tube falls out or is removed.[13]
  4. Discuss the possibility of an adenoidectomy to remove swollen adenoids with your doctor. If you continue to have swollen adenoids, which are masses of tissue located behind the nasal cavity, they may need to be surgically removed.[29][9]

Preventing Ear Infections

  1. Keep all immunizations up-to-date. Many of the serious strains of bacterial infections can be prevented with immunizations. Seasonal flu shots and pneumococcal vaccines will likely help reduce ear infections.[30]
    • You and every member of your family should also get a flu vaccination every year. Vaccinating yourself will help keep both you and your family safer from infection.[31]
    • Experts recommend that you use the PCV13 pneumococcal conjugate vaccination for children. Ask your pediatrician for advice.[9]
  2. Keep your child’s hands, toys, and play surfaces clean. Wash your child's hands, toys and play surfaces frequently to reduce the likelihood of infection.[5]
  3. Avoid giving your child pacifiers. Pacifiers can be vectors for bacteria, including bacteria that causes ear infections.[5]
  4. Breastfeed instead of bottle-feeding. Leakage is more likely to occur in bottle-feeding than it is in breastfeeding, making the transmission of bacteria higher.
    • Breastfeeding also boosts your child’s immune system, helping him or her to fight off infections easier.[32]
    • If bottle-feeding is necessary, place the child in an upright seat so that liquids drip down instead of possibly into their ear.[29]
    • Never give a baby a bottle while s/he is going down for a nap or to sleep at night.[9]
  5. Reduce your exposure to secondhand smoke. Do this both for the sake of preventing ear infections and for general health and safety.
  6. Don't abuse antibiotics. Prolonged usage of antibiotics can leave certain bacteria in your body or your child's body resistant to the effects of certain drugs. Only use antibiotics when prescribed by your doctor, or when other options aren't available.[5]
  7. Avoid sending your child to daycare or take precautions. These facilities put your child at a 50% greater chance of developing an ear infection due to the common transmission of infections both bacterial and viral.[33]
    • If you cannot avoid sending your child to daycare, teach him or her a few tactics to help avoid the spread of infections such as colds, which can cause ear infections.[34]
    • Teach your child not to put toys or fingers in his or her mouth. S/he should avoid touching the face with his or her hands, especially mucous membrane areas such as the mouth, eyes, and nose. S/he should wash hands after eating and after using the bathroom.[34]
  8. Eat a healthy diet that includes probiotics. Eating a wide variety of fresh fruits and vegetables, whole grains, and lean proteins helps your body stay strong and healthy. Some research also suggests that "good" bacteria such as probiotics may help protect your body from infection.[20]
    • Acidophilus is a commonly studied strain of probiotic. You can find it in many yogurts.

Related Articles

Sources and Citations

  1. ↑ http://www.ncbi.nlm.nih.gov/pubmed/2732519
  2. ↑ http://pediatrics.aappublications.org/content/early/2013/02/20/peds.2012-3488
  3. ↑ http://www.ncbi.nlm.nih.gov/pubmed/6117681
  4. ↑ http://www.nidcd.nih.gov/health/hearing/pages/earinfections.aspx
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 http://www.nlm.nih.gov/medlineplus/ency/article/000638.htm
  6. ↑ http://www.emedicinehealth.com/wilderness_ear_infection/article_em.htm
  7. ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 http://www.mckinley.illinois.edu/handouts/ear_infection/ear_infection_.htm
  8. ↑ http://www.mayoclinic.org/diseases-conditions/swimmers-ear/basics/symptoms/con-20014723
  9. ↑ 9.0 9.1 9.2 9.3 http://www.nidcd.nih.gov/health/hearing/pages/earinfections.aspx#4
  10. ↑ http://www.mayoclinic.org/diseases-conditions/ear-infections/basics/symptoms/con-20014260
  11. ↑ 11.0 11.1 http://www.mayoclinic.org/diseases-conditions/ear-infections/basics/tests-diagnosis/con-20014260
  12. ↑ http://www.ncbi.nlm.nih.gov/pubmed/14506123
  13. ↑ 13.0 13.1 13.2 13.3 13.4 13.5 http://www.mayoclinic.org/diseases-conditions/ear-infections/basics/treatment/con-20014260
  14. ↑ http://www.mayoclinic.org/diseases-conditions/ear-infections/basics/complications/con-20014260
  15. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305770/
  16. ↑ http://www.nlm.nih.gov/medlineplus/ency/article/001565.htm
  17. ↑ http://everydayroots.com/how-to-make-your-own-hot-or-cold-compress
  18. ↑ https://healthychildren.org/English/tips-tools/Symptom-Checker/Pages/Ear-Infection-Questions.aspx
  19. ↑ http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/water/art-20044256
  20. ↑ 20.0 20.1 http://umm.edu/health/medical/reports/articles/ear-infections
  21. ↑ http://www.webmd.com/ear-infection?page=2
  22. ↑ http://www.ncbi.nlm.nih.gov/pubmed/11434846
  23. ↑ http://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/basics/definition/con-20023778
  24. ↑ http://www.mayoclinic.com/health/ruptured-eardrum/DS00499
  25. ↑ http://www.webmd.com/cold-and-flu/ear-infection/ear-infections-home-treatment
  26. ↑ http://www.webmd.com/cold-and-flu/ear-infection/ear-infections-treatment-overview?page=2
  27. ↑ http://www.tufts.edu/med/apua/about_issue/about_antibioticres.shtml
  28. ↑ 28.0 28.1 http://www.medicinenet.com/antipyrine_with_benzocaine-otic/article.htm
  29. ↑ 29.0 29.1 http://www.webmd.com/cold-and-flu/ear-infection/understanding-otitis-media-treatment?page=2
  30. ↑ http://www.mayoclinic.org/diseases-conditions/ear-infections/basics/prevention/con-20014260
  31. ↑ http://www.cdc.gov/flu/protect/keyfacts.htm
  32. ↑ https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Breastfeeding-Benefits-Your-Baby's-Immune-System.aspx
  33. ↑ http://www.ncbi.nlm.nih.gov/pubmed/8783714
  34. ↑ 34.0 34.1 http://www.entnet.org/content/day-care-and-ear-nose-and-throat-problems

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