Ear Infection: Symptoms, Treatment and What Not to Put in the Ear

A child who wakes at night crying, pulling at one ear, with a fever and a blocked nose. An adult with a throbbing ear after a swim or a bath. Ear infections are one of the commonest reasons for a visit to the doctor, and the pain can be severe. Most are not dangerous and settle with the right care, but there are a few mistakes that can make them worse, and some of them are very common in Pakistan.

Types of ear infection

• Middle ear infection (otitis media): infection behind the eardrum, usually after a cold, sore throat or sinus infection. It is most common in babies and young children.
• Outer ear infection (otitis externa): infection of the ear canal, often called swimmer’s ear. It follows water in the ear, scratching with cotton buds, hairpins or matchsticks, or wearing earphones for long hours.

Ear infection symptoms

In older children and adults:

• Ear pain, sometimes severe and worse at night
• Muffled hearing or a feeling of fullness
• Fever
• Fluid or pus draining from the ear
• For an outer ear infection, itching in the canal and pain when the earlobe is touched or pulled

In babies and toddlers, look for pulling or rubbing at the ear, crying, irritability, poor feeding, trouble sleeping, fever and sometimes vomiting or diarrhoea.

Do ear infections need antibiotics?

Not always. Many middle ear infections in children over two years old with mild symptoms clear up by themselves within two to three days, and doctors may advise waiting while treating the pain. Antibiotics, usually amoxicillin first, are generally used for babies and young children, for high fever, severe pain, discharge, or when symptoms do not improve after a couple of days. Outer ear infections are usually treated with antibiotic ear drops, sometimes combined with a steroid to reduce swelling. Only a doctor can decide which, because they need to look into the ear.

Pain relief at home

• Paracetamol or ibuprofen, in the dose suitable for the child’s age and weight, as given by your doctor
• A warm cloth held against the ear
• Keeping the child’s head slightly raised while resting
• Plenty of fluids

What you should not do

• Do not pour oil, garlic oil, onion juice, milk or any home remedy into the ear. They can irritate the canal, hide the problem, and are dangerous if the eardrum has a hole.
• Do not use ear drops from an old prescription, because some drops are unsafe if the eardrum is perforated.
• Do not clean the ear with cotton buds, pins or matchsticks.
• Do not give antibiotics left over from another illness.
• Keep water out of the ear during an infection and avoid swimming until the doctor says it has healed.

How to prevent ear infections

• Breastfeed babies if you can, and avoid feeding a baby lying flat.
• Keep your child up to date on vaccines, including the pneumococcal vaccine and yearly flu vaccine.
• Keep children away from cigarette smoke.
• Treat colds and allergies early, and wash hands often.
• Dry the outer ear gently after a bath or swim and avoid inserting anything into it.
• Keep earphone volume low and take breaks from them.

When to see a doctor

• A baby under 6 months with fever or ear pain
• Ear pain that lasts more than two to three days, or any pus or blood from the ear
• Hearing loss, or repeated ear infections
• Swelling or redness behind the ear
• Severe headache, stiff neck, facial weakness, dizziness or a child who is very drowsy. These are urgent signs.

Key takeaways

• Middle ear infections follow colds in children, and outer ear infections follow water and cotton buds.
• Many mild cases settle in two to three days, but a doctor should examine the ear.
• Never put oil or home remedies in an aching ear.
• Swelling behind the ear, severe headache or stiff neck are emergencies.

Related medicines on Medimart

These are commonly prescribed for ear infections and ear pain:

• Amoxicillin: a common first antibiotic for middle ear infection
• Ciprofloxacin and dexamethasone: antibiotic and steroid ear drops
• Ofloxacin: antibiotic ear drops
• Paracetamol: for pain and fever
• Ibuprofen: for pain and inflammation

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse ear infection medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Please have an aching ear examined, especially in a baby.