Middle ear infection (otitis media)
Middle ear infection (otitis media)
Otitis media is a middle ear infection. It causes redness, swelling and fluid build-up behind the eardrum.
It can affect anyone, but is most common in young children.
You do not always need to see a doctor, as most ear infections clear up on their own within 3 to 5 days.
Common Symptoms
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
When to See a Doctor
When to get medical advice
Speak to your GP practice if:
You or your child has:
- symptoms that do not improve within 2 or 3 days
- regular ear infections
- a lot of pain
- a discharge of pus or fluid from the ear
- an underlying health condition, such as cystic fibrosis or congenital heart disease, which could make complications more likely
If your GP practice is closed, phone 111.
Causes
What causes middle ear infections?
Most cases start with an ordinary infection, such as a cold, that leads to mucus building up in the middle ear. This causes the Eustachian tube (a thin passage running from the middle ear to the back of the nose) to become swollen or blocked. Once that happens, the mucus can't drain away properly, and this makes it easier for the infection to spread into the middle ear.
An enlarged adenoid (soft tissue at the back of the throat) can also block the Eustachian tube. If this keeps causing ear infections, the adenoid can be removed.
Middle ear infections are more common in younger children, for two reasons:
- their Eustachian tube is smaller than an adult's
- a child's adenoids are relatively larger than an adult's
Certain conditions can also raise the risk of middle ear infections, including:
- having a cleft palate
- having Down's syndrome
Treatment
Treatment for middle ear infections
Most ear infections get better on their own within 3 to 5 days and do not need any specific treatment.
If needed, paracetamol or ibuprofen can be used to relieve pain and a high temperature. Always read the leaflet that comes with your medicine before taking it. Follow the recommended dosage instructions. If you’re not sure which treatments are suitable for you or your child, speak to a pharmacist for advice.
Placing a warm cloth over the affected ear may also help relieve pain.
Antibiotics are not usually used to treat middle ear infections.
Prevention
Can middle ear infections be prevented?
There is no sure way to prevent middle ear infections, but a few steps may lower your child's risk.
Do
- keep your child up-to-date with routine vaccinations, especially the pneumococcal vaccine and the DTaP/IPV/Hib/HepB (6-in-1) vaccine
- if possible, feed your baby breast milk rather than formula milk
Don't
- do not let your child be around smoky environments (passive smoking)
- do not give your child a dummy once they are older than 12 months
- do not feed your child while they are lying flat on their back
Children who go to nursery or school can pick up infections from other children who are unwell.
Complications
Complications from a middle ear infection are uncommon, but when they happen, they shouldn't be ignored. Most arise because the infection has spread beyond the ear to nearby areas of the head. In rare cases, it can even leave a small perforation, or hole, in the eardrum.
If a complication does develop, it usually needs prompt treatment with antibiotics in hospital, so it's important to get medical attention quickly rather than wait it out at home.