Antibiotics for Ear Infections: What Are Your Options?

By Jenell Decker, MD
Medically reviewed
September 24, 2021

Ear infections are incredibly common in children, and they can also affect adults.

Oftentimes ear infections go away in a few days without any treatment. When an ear infection is severe or doesn’t resolve on its own, though, antibiotics may be a necessary and effective treatment. 

In this article, I’ll describe the different types of ear infections that affect children and adults.

Then I’ll discuss the antibiotics used to treat ear infections and their possible side effects.

Finally, I’ll explain other treatment options, how best to prevent ear infections, and when you should speak with your doctor or pediatrician.

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Types of Ear Infections

An ear infection is an infection or inflammation of the middle, inner, or outer ear. 

Middle ear infections

Middle ear infections (or acute otitis media) are the most common type of ear infection.

They occur when fluid is unable to drain from the middle ear, the space located behind the eardrum that’s normally filled with air.

A middle ear infection can come on quickly and cause redness, swelling, fever, and pain, and often results in trapped fluid and pus under the eardrum.

In some cases, you or your child may also experience temporary hearing impairment. Most middle ear infections are caused by bacteria or viruses.

Inner ear infections 

An inner ear infection is inflammation or irritation of the inner parts of the ear responsible for hearing and balance.

That’s why symptoms include hearing impairment and vertigo. This infection can also be caused by a virus or bacteria. 

Outer ear infections (swimmer’s ear)

Swimmer’s ear, sometimes called otitis externa, is a bacterial infection typically caused by water in the outer ear canal that stays in the ear after swimming.

Anyone can get swimmer’s ear, but it is most common in children.

You can also get an outer ear infection by putting cotton swabs, fingers, or other objects in your ear.

Are Oral Antibiotics Used to Treat Ear Infections?

Ototopical antibiotics, or antibiotics administered topically into the ear, are usually the first-line treatment for recurrent bacterial infections because they can contain a greater concentration of medication than oral antibiotics. 

Some examples of ototopical antibiotics used to treat bacterial ear infections are:

  • Neomycin/polymyxin b/hydrocortisone (Cortisporin)
  • Ciprofloxacin/dexamethasone (Ciprodex)
  • Ofloxacin (Floxin, Ocuflox) 

But oral antibiotics may be prescribed to treat some bacterial ear infections, particularly when the infection spreads outside of the ear canal or in the case of severe infections and infections that last longer than 2-3 days.

Some examples of oral antibiotics used to treat ear infections are: 

Side Effects of Antibiotic Use

Antibiotic treatment can effectively remedy an ear infection.

At the same time, side effects may occur anytime you take antibiotics.

That’s why it’s important to discuss any known allergies, medical conditions, and current medications you take with your healthcare provider.

That information helps them prescribe the most appropriate antibiotic for you.

When taking antibiotics, be mindful of the following common side effects:

Some people have allergic reactions to antibiotics.

If you notice any of the following, contact your doctor. Or, if you’re having a severe allergic reaction, call 911 or go to the emergency room:

  • Rash
  • Itching
  • Wheezing or breathing problems
  • Swelling of the throat

Other Treatment Options

Most middle ear infections go away without any treatment within 2-3 days, while inner ear infections take a few weeks to resolve on their own.

No matter the type of ear infection, your healthcare provider may recommend treatments in addition to or in place of antibiotics to help clear the infection:

Antibiotic ear drops

Antibiotic ear drops (also called ototopical antibiotics) are the go-to treatment for recurrent bacterial ear infections. Since they don’t enter the bloodstream, these have fewer side effects than oral antibiotics.

Over-the-counter (OTC) options 

For mild ear infections, OTC pain relievers may help soothe aches and fever until the infection clears.

Be sure to talk to your doctor about which OTC pain medication they recommend, particularly for children, who should never take aspirin.

Common OTC pain relievers for ear infections include acetaminophen (Tylenol) and ibuprofen (Advil). 

If you or your child suffer from ear infections triggered by allergies, some OTC allergy medications may help reduce swelling in the mucous membranes and open up the eustachian tubes.

Talk to your doctor before trying any OTC allergy medication for an ear infection, as these will only help if the infection is caused by allergies.

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Surgery 

For more severe or chronic ear infection cases, your doctor may recommend a surgical procedure called a myringotomy.

During this procedure, a surgeon creates a small hole in the eardrum to drain fluid from the ear.

Then they place a small tube (called a tympanostomy tube) in your ear to keep fluid from building up and to help relieve pressure in the middle ear. The tube usually falls out on its own within 4-18 months.

Prevention Tips

It isn’t always possible to prevent ear infections, especially those caused by bacterial or viral infections.

However, there are some things you can do to help prevent you or your child from getting ear infections:

  • Wash hands well and often: This will help prevent the spread of germs, some of which can cause ear infections.
  • Don’t smoke: And also try to reduce or eliminate your exposure to secondhand smoke.
  • Get vaccinated: Staying up to date with vaccines (especially the flu vaccine) may help prevent ear infections.
  • Manage your allergies: If allergies trigger your ear infections, talk with your doctor about the best measures to control your allergies.
  • Hydrogen peroxide: This home prevention remedy may work particularly for swimmer’s ear by removing ear wax that can trap water and bacteria in your ear. Talk to your doctor or ENT before trying hydrogen peroxide, though.

When to Talk to a Doctor

If you notice persistent ear infection symptoms that don’t resolve on their own, call a healthcare professional.

This is particularly important for adults, as a middle ear infection can be a sign of a more serious problem in this age group compared to children.

And if you experience chronic ear infections, talk to your primary care provider, an otolaryngologist (ear, nose, and throat specialist), or an otologist (ear subspecialist) to discuss treatment options.

Which antibiotics are used for infections?
Several antibiotics, including oral and ear drop antibiotics, can be used to treat ear infections. Examples of antibiotics used to treat ear infections include amoxicillin (Amoxil), ofloxacin (Floxin Otic), and cephalexin (Keflex).
Can you get rid of an ear infection without an antibiotic?
Many ear infections go away on their own in a few days. However, if your symptoms persist or if you experience recurrent middle ear infections, talk to your doctor. Also see your child’s pediatrician if they have a fever with an ear infection. In either case, your healthcare provider can determine the best treatment course, which may or may not include antibiotics.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Jenell Decker, MD

Dr. Decker is a family medicine physician who completed her residency at East Carolina University School of Medicine. She graduated medical school from Marshall University School of Medicine.