If your child's condition improves in the first couple of days, treating the symptoms at home may be all that is needed. For more information, see Home Treatment.
If your child isn't better after a couple of days of home treatment, call your doctor. He or she may prescribe antibiotics.
Follow-up exams with a doctor are important to check for persistent infection, fluid behind the eardrum (otitis media with effusion), or repeat infections. Even if your child seems well, he or she may need a follow-up visit in about 4 weeks, especially if your child is young.
Your doctor can give your child antibiotics, but ear infections often get better without them. Talk about this with your doctor. Whether you use antibiotics will depend on how old your child is and how bad the infection is. For more information, see Medications.
If your child has cochlear implants, your doctor will probably prescribe antibiotics, because serious complications of ear infections, including bacterial meningitis, are more common in children who have cochlear implants than in children who do not have cochlear implants.
Repeat ear infections
If a child has repeat ear infections (three or more ear infections in a 6-month period or four in 1 year), you may want to consider treatment to prevent future infections.
One option that has been used a lot in the past is long-term oral antibiotic treatment. There is debate within the medical community about using antibiotics on a long-term basis to prevent ear infections. Many doctors don't want to prescribe long-term antibiotics, because they are not sure that they really work. Also, when antibiotics are used too often, bacteria can become resistant to antibiotics.
Having tubes put in the ears is another option for treating repeat ear infections.
Fluid buildup and hearing problems
Fluid behind the eardrum after an ear infection is normal. And in most children, the fluid clears up within 3 months without treatment. If your child has fluid buildup without infection, you may try watchful waiting.
Have your child's hearing tested if the fluid lasts longer than 3 months. If hearing is normal, you may choose to keep watching your child without treatment.
If a child has fluid behind the eardrum for more than 3 months and has significant hearing problems, then treatment is needed. Sometimes short-term hearing loss occurs, which is especially a concern in children ages 2 and younger. Normal hearing is very important when young children are learning to talk.
If your child is younger than 2, your doctor may not wait 3 months to start treatment. Hearing problems at this age could affect your child's speaking ability. This is also why children in this age group are closely watched when they have ear infections.
If there is a hearing problem, your doctor may also prescribe antibiotics to help clear the fluid. The doctor might also suggest placing tubes in the ears to drain the fluid and improve hearing.
Doctors may consider surgery for children who have repeat ear infections or for those who have persistent fluid behind the eardrum. Procedures include inserting ear tubes or removing adenoids and, in rare cases, the tonsils. For more information, see Surgery.
Treating other problems
Children who get rare but serious problems from ear infections, such as infection in the tissues around the brain and spinal cord (meningitis) or infection in the bone behind the ear (mastoiditis), need treatment right away.