What your doctor will do first
When you see a doctor for an ear infection, they will look inside your ear with an otoscope—a small handheld light—to see whether the eardrum is inflamed and whether fluid has built up behind it. This takes a few minutes and is painless. The doctor may also ask about your symptoms: how long the pain has lasted, whether you have fever, and whether you have had ear infections before.
Based on what they see, your doctor will decide whether the infection is bacterial, viral, or caused by fluid buildup alone. This matters because treatment depends on the type. A bacterial infection may need antibiotics. A viral infection will not respond to antibiotics and usually clears on its own. Fluid without active infection may need only time and monitoring.
Your doctor may also check your temperature and look at your throat, since ear infections sometimes happen alongside sore throats or upper respiratory infections. If the infection looks severe or you have had repeated infections, they may refer you to an ear, nose, and throat specialist (ENT).
Key Takeaways
- Bacterial ear infections are treated with antibiotics taken by mouth, usually for 7 to 10 days, while viral infections clear without antibiotics.
- Pain relief with over-the-counter ibuprofen or acetaminophen works for most ear infections while your body fights the infection or antibiotics take effect.
- Warm compresses and keeping water out of your ear during bathing can ease discomfort and prevent the infection from worsening.
- Most ear infections resolve within 1 to 2 weeks, but you should see a doctor if pain is severe, fever is high, or symptoms last longer than 3 days.
- Repeated infections or infections that do not clear may lead to hearing tests or placement of ear tubes, especially in young children.
Antibiotics: when they are used and how they work
Antibiotics are prescribed when your doctor believes bacteria are causing the infection. The most common choice is amoxicillin, taken by mouth three times a day for 7 to 10 days. Other options include amoxicillin-clavulanate (Augmentin), azithromycin (Z-pack), or cephalexin, depending on what bacteria your doctor suspects and whether you have allergies.
Antibiotics work by killing bacteria or stopping them from multiplying. You should start feeling better within 24 to 48 hours—pain usually decreases and fever drops. It is important to finish the full course even if you feel better, because stopping early can allow bacteria to survive and cause the infection to return or become resistant to the antibiotic.
If you do not feel better after 48 to 72 hours on antibiotics, call your doctor. The bacteria may be resistant to that particular antibiotic, or the infection may not be bacterial. Your doctor may switch you to a different antibiotic or do further testing.
Pain relief while the infection clears
Over-the-counter pain relievers reduce ear pain and fever while your body fights the infection or antibiotics take effect. Ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) both work, and some people find ibuprofen more effective because it also reduces inflammation. Follow the dosage on the package for your age and weight, and do not exceed the maximum daily dose.
A warm compress—a clean washcloth soaked in warm (not hot) water and held against the ear for 10 to 15 minutes—can ease pain. Some people find that lying on the unaffected side helps. Avoid putting anything into the ear canal, including cotton swabs or eardrops, unless your doctor has prescribed them.
If pain is severe and over-the-counter medication is not enough, your doctor may prescribe stronger pain relief temporarily. This is uncommon but can happen with severe infections or in very young children who cannot take standard doses.
Caring for your ear while it heals
Keep water out of your ear during bathing and showering. Water trapped in the ear canal can worsen the infection or prevent it from healing. Use a cotton ball lightly coated with petroleum jelly as a barrier, or wear an earplug designed for bathing. Remove it as soon as you are done.
Avoid swimming, diving, or submerging your head until your doctor says the infection has cleared. Even a few days in a pool or ocean can introduce new bacteria or prevent healing.
If you have ear tubes (small plastic tubes placed through the eardrum to allow fluid to drain), water precautions are especially important. Your doctor will give you specific instructions about earplugs or custom-fitted ear molds to use during water activities.
When infections do not clear or keep returning
Most ear infections resolve within 1 to 2 weeks with treatment. If yours does not improve after 3 days of antibiotics, or if pain and fever return after treatment seems complete, contact your doctor. They may take a sample of fluid from the ear to identify the exact bacteria and choose a better antibiotic.
If you have more than three ear infections in six months or more than four in a year, your doctor may refer you to an ENT specialist. Repeated infections can mean fluid is not draining properly, your eustachian tubes (the small tubes connecting your ear to your throat) are not working well, or you have an underlying issue like enlarged adenoids.
In children with repeated infections, an ENT may recommend ear tubes. These are tiny plastic tubes inserted through the eardrum during a brief surgical procedure. They allow fluid to drain and air to reach the middle ear, preventing infection buildup. Tubes usually fall out on their own within 6 to 12 months.
Hearing and follow-up after infection
Temporary hearing loss during an ear infection is common because fluid behind the eardrum blocks sound. Hearing usually returns to normal within a few weeks after the infection clears and fluid drains. If hearing does not improve after 3 months, or if you have had repeated infections, your doctor may order a hearing test.
Children are at higher risk for lasting hearing problems from repeated infections, especially if infections happen before age three when language develops. If your child has had multiple infections, a hearing test can show whether fluid is still present or whether the eardrum has been damaged.
Most people do not need follow-up appointments after a simple ear infection clears. However, if you were prescribed antibiotics, your doctor may ask you to call back in a week to confirm you are better. If you have ear tubes or a history of repeated infections, you will see your ENT periodically to monitor healing and plan next steps.
Preventing future ear infections
Ear infections often follow colds or sore throats because viruses inflame the eustachian tubes and allow bacteria to move into the middle ear. Washing your hands regularly and avoiding close contact with people who are sick reduces your risk of catching these upper respiratory infections in the first place.
If you swim frequently, dry your ears thoroughly after swimming. Tilt your head to each side and gently pull your earlobe to help water drain. Some swimmers use alcohol-based ear drops after swimming to dry the canal, though this is not necessary for everyone.
Avoid inserting objects into your ear canal—including earbuds, hearing aids, or earwax removal tools—without cleaning them first. Bacteria on these objects can cause infection. If you use hearing aids or earbuds regularly, clean them according to the manufacturer's instructions.
Frequently Asked Questions
Can I treat an ear infection without seeing a doctor?
Pain relievers and warm compresses can ease discomfort, but you should see a doctor if pain is severe, you have fever, or symptoms last more than a day or two. Your doctor needs to look inside your ear to know whether antibiotics will help. Untreated bacterial infections can lead to complications like a ruptured eardrum or spread of infection to nearby bone.
How long does it take for antibiotics to work?
Most people feel better within 24 to 48 hours of starting antibiotics—pain decreases and fever drops. However, you should take the full course (usually 7 to 10 days) even if you feel better, because stopping early can allow the infection to return or bacteria to become resistant.
What should I do if my ear is draining pus or blood?
Drainage usually means the eardrum has ruptured, which allows pressure and infection to release. This is painful but often leads to faster healing. Contact your doctor the same day so they can confirm the rupture and monitor healing. Most ruptured eardrums heal on their own within a few weeks without treatment.
Are ear infections contagious?
The ear infection itself is not contagious, but the virus or bacteria that caused it may be. If your infection started with a cold or sore throat, you could spread that illness to others. Wash your hands frequently and avoid sharing drinks or utensils until your fever is gone.
When should I see a specialist instead of my regular doctor?
See an ENT specialist if you have had more than three infections in six months, if an infection does not clear after two weeks of antibiotics, or if you have hearing loss that does not improve after the infection heals. Your regular doctor can refer you.